Published in:
Open Access 01-06-2019 | Cardiomyopathy | Original Article
Large next-generation sequencing gene panels in genetic heart disease: challenges in clinical practice
Published in: Netherlands Heart Journal | Issue 6/2019
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Background
Next-generation sequencing gene panels are increasingly used for genetic diagnosis in inherited cardiac diseases. Besides pathogenic variants, multiple variants, variants of uncertain significance (VUS) and incidental findings can be detected. Such test results can be challenging for counselling and clinical decision making.
Methods
We present patient cases to illustrate the challenges that can arise when unclear genetic test results are detected in cardiogenetic gene panels.
Results
We identified three types of challenging gene panel results: 1) one or more VUS in combination with a pathogenic variant, 2) variants associated with another genetic heart disease, and 3) variants associated with a syndrome involving cardiac features.
Conclusion
Large gene panels not only increase the detection rates of pathogenic variants but also of variants with uncertain pathogenicity, multiple variants and incidental findings. Gene panel results can be challenging for genetic counselling and require proper pre-test and post-test counselling. We advise evaluation of challenging cases by a multidisciplinary team.