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Novel NKX2.5 variant associated with congenital heart disease and increased risk of malignant arrhythmia and sudden cardiac death

Published online by Cambridge University Press:  12 September 2023

Benjamin M. Helm Open the ORCID record for Benjamin M. Helm [Opens in a new window] ,
Rebecca Baud ,
Laura Shopp ,
Adam C. Kean Open the ORCID record for Adam C. Kean [Opens in a new window]  and
Mark D. Ayers
Benjamin M. Helm*
Affiliation:
Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA Department of Epidemiology, Indiana University Fairbanks School of Public Health, Indianapolis, IN, USA
Rebecca Baud
Affiliation:
Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
Laura Shopp
Affiliation:
Department Pediatrics, Division of Pediatric Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA
Adam C. Kean
Affiliation:
Department Pediatrics, Division of Pediatric Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA
Mark D. Ayers
Affiliation:
Department Pediatrics, Division of Pediatric Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA
*
Corresponding author: B. M. Helm; Email: bmhelm@iu.edu
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Abstract

Introduction:

The NKX2.5 gene is an important cardiac developmental transcription factor, and variants in this gene are most commonly associated with CHD. However, there is an increased need to recognise associations with conduction disease and potentially dangerous ventricular arrhythmias. There is an increased risk of arrhythmia and sudden cardiac death in patients with NKX2.5 variants, an association with relatively less attention in the literature.

Methods:

We created a family pedigree and reconstructed familial relationships involving numerous relatives with CHD, conduction disease, and ventricular non-compaction following the sudden death of one family member. Two informative but distantly related family members had genetic testing to determine the cause of arrhythmias via arrhythmia/cardiomyopathy gene testing, and we identified obligate genetic-positive relatives based on family relationships and Mendelian inheritance pattern.

Results:

We identified a novel pathogenic variant in the NKX2.5 gene (c.437C > A; p. Ser146*), and segregation analysis allowed us to link family cardiac phenotypes including CHD, conduction disease, left ventricular non-compaction, and ventricular arrhythmias/sudden cardiac death.

Conclusions:

We report a novel NKX2.5 gene variant linking a spectrum of familial heart disease, and we also encourage recognition of the association between NKX2.5 gene and potentially dangerous ventricular arrhythmias, which will inform clinical risk stratification, screening, and management.

Keywords

NKX2.5conduction diseasesudden cardiac deathCHD
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 3 , March 2024 , pp. 654 - 658
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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