NGS Dilated & Arrhythmogenic Cardiomyopathies Panel

 

Disorder

 Dilated Cardiomyopathy

Arrhythmogenic right ventricular dysplasia

Clinical info

Familial dilated cardiomyopathy (DCM) is associated with thinning of cardiac muscle, resulting in enlargement of the affected chamber(s). Reduced efficiency of cardiac blood flow causes progressive thinning which, untreated, may result in heart failure. Onset of symptoms typically occurs in adulthood, and these include arrhythmia, dyspnea, extreme fatigue, exercise intolerance, syncope, and swelling of the lower extremities. In some cases, sudden cardiac death in an undiagnosed or asymptomatic individual can occur.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) occurs when right ventricular tissue breaks down and is replaced by fat and scar tissue. Heart palpitations, syncope, and swelling of the legs can occur. In addition, cardiac arrest may be triggered by exercise, so sudden death in young athletes has been reported with this condition. Disease presentation is highly variable, even within families.

Treatments include pharmocologic therapies, implanted defibrillators, and in severe cases, heart transplant. While some types demonstrate autosomal recessive or X-linked inheritance, most forms are inherited in an autosomal dominant pattern. This panel consists of 51 genes that are associated with these conditions.

List of Genes and Associated Clinical Phenotypes

Indications

Molecular testing is useful to confirm the diagnosis and to identify the disease causing mutations within a family to allow for carrier testing and prenatal diagnosis.

Detection

The current design of the dilated and arrhythmogenic cardiomyopathy panel covers the coding region for all 51 genes and the flanking intronic sequences. This method allows for analysis of greater than 98% of the targeted sequence for the detection of nucleotide substitutions and small deletions and duplications. Large deletions and duplications will not be detected by this panel. Mutations and variants identified on the panel are confirmed with Sanger sequencing. All novel and apparently pathogenic changes are reported when found within the coding region as well as within 10 basepairs of each intron/exon boundary for each gene. Promoter and 3' untranslated sequences are not included in the current analysis. It should be noted that the current protocol is not specifically designed to detect copy number alterations and single exon deletions may require additional follow-up to determine whether or not they represent technical artifacts.

We recommend further array-based testing to more accurately address the concerns of dosage alterations. The Cytogenetic Laboratory at GGC offers a high resolution whole genome SNP microarray. The GGC Diagnostic Laboratory Directors are available for further consultation regarding the limitations of the NGS and array testing procedures.

Associated Tests

This analysis is a subpanel of the NGS Cardiac Panel.

Effective January 1, 2017, all NGS panels are performed on an exome backbone with the potential for reflex to whole exome sequencing at a reduced cost. Please contact the laboratory to discuss the requirements for exome sequencing.

Specimen Requirements 5 to 10 ml of peripheral blood collected in an EDTA (lavender top) Vacutainer tube is preferred. The minimal blood needed for reliable DNA isolation is 3 ml.
Transport The specimen should be kept at room temperature and delivered via overnight shipping. FedEx is preferred. If shipment is delayed by one or two days, the specimen should be refrigerated and shipped at room temperature. Do not freeze the specimen.  Samples collected on Friday can be safely designated for Monday delivery.
Turnaround time 8-10 weeks
Prenatal testing

If pathogenic mutation(s) are identified in an affected individual using this panel, prenatal diagnosis is available for future pregnancies. Sanger sequencing will be used for prenatal diagnosis when there is a known familial mutation. Additional fees for cell culture and maternal cell contamination may apply. Maternal cell contamination studies are required for all prenatal molecular tests. Contact the laboratory prior to sending a prenatal specimen.

CPT Codes 81439
Cost $3500

Insurance billing is available for this test. The Billing Form is required along with copies of the authorization or letter of agreement from the insurance company.
Contact For further information contact one of our This email address is being protected from spambots. You need JavaScript enabled to view it. at 1-800-473-9411.

NGS Panel Requisition Form

Please submit a completed Requisition Form with all samples.

 

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Molecular Diagnostic Lab Faculty

Clearing Div - do not delete (is not shown)