Rare RYR2 p.Thr85Ile variant is associated with catecholaminergic polymorphic ventricular tachycardia. 2020

Utkarsh Kohli, and Rayyan S Hassan, and David K Lawrence
Assistant Professor of Pediatrics, Director of Pediatric Electrophysiology, Section of Pediatric Cardiology, Department of Pediatrics, Comer Children's Hospital and The University of Chicago Pritzker School of Medicine, Chicago, IL, USA. Electronic address: ukohli@peds.bsd.uchicago.edu.

Mutations in the cardiac ryanodine receptor 2 gene (RYR2) are noted in approximately 55% of the patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). However, a high background rate of rare amino acid-altering variants in RYR2 [≈3% (whites) to 6% (nonwhites)] in combination with delayed onset and variable expressivity of the CPVT phenotype make attributing causality to rare RYR2 variants difficult. The proposed set of guidelines for characterization of variants include, among many different criteria, functional studies to classify variants as pathogenic versus non- pathogenic. However, in vitro data, especially for complex channelopathies like CPVT, does not always correlate well with the human phenotype; therefore, characterizing the phenotypic features of rare RYR2 variants in humans is of importance. We report a 13-year-old carrier of a rare maternally inherited variant in exon 3 of RYR2 (p.Thr85Ile, c.254C>T [rs772005577]) who was successfully resuscitated from exercise-associated sudden cardiac arrest and was subsequently found to have exercise-induced complex ventricular ectopy. His brother, who has been asymptomatic, was also found to carry the same variant and demonstrated complex ventricular ectopy on exercise stress testing. These findings suggest that this rare variant, which has previously not been reported in patients with RYR2 related conditions, is associated with pathogenicity.

UI MeSH Term Description Entries
D008297 Male Males
D009154 Mutation Any detectable and heritable change in the genetic material that causes a change in the GENOTYPE and which is transmitted to daughter cells and to succeeding generations. Mutations
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D016757 Death, Sudden, Cardiac Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005) Cardiac Sudden Death,Sudden Cardiac Death,Cardiac Arrest, Sudden,Sudden Cardiac Arrest,Arrest, Sudden Cardiac,Cardiac Arrests, Sudden,Cardiac Death, Sudden,Death, Cardiac Sudden,Death, Sudden Cardiac,Sudden Death, Cardiac
D017180 Tachycardia, Ventricular An abnormally rapid ventricular rhythm usually in excess of 150 beats per minute. It is generated within the ventricle below the BUNDLE OF HIS, either as autonomic impulse formation or reentrant impulse conduction. Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation). Idiopathic Ventricular Tachycardia,Nonsustained Ventricular Tachycardia,Paroxysmal Supraventricular Tachycardia,Ventricular Tachyarrhythmias,Ventricular Tachycardia,Idiopathic Ventricular Tachycardias,Nonsustained Ventricular Tachycardias,Paroxysmal Supraventricular Tachycardias,Supraventricular Tachycardia, Paroxysmal,Tachyarrhythmia, Ventricular,Tachycardia, Idiopathic Ventricular,Tachycardia, Nonsustained Ventricular,Tachycardia, Paroxysmal Supraventricular,Ventricular Tachyarrhythmia,Ventricular Tachycardia, Idiopathic,Ventricular Tachycardia, Nonsustained,Ventricular Tachycardias
D019837 Ryanodine Receptor Calcium Release Channel A tetrameric calcium release channel in the SARCOPLASMIC RETICULUM membrane of SMOOTH MUSCLE CELLS, acting oppositely to SARCOPLASMIC RETICULUM CALCIUM-TRANSPORTING ATPASES. It is important in skeletal and cardiac excitation-contraction coupling and studied by using RYANODINE. Abnormalities are implicated in CARDIAC ARRHYTHMIAS and MUSCULAR DISEASES. Calcium-Ryanodine Receptor Complex,RyR1,Ryanodine Receptor 1,Ryanodine Receptor 2,Ryanodine Receptor 3,Ryanodine Receptors,Ca Release Channel-Ryanodine Receptor,Receptor, Ryanodine,RyR2,RyR3,Ryanodine Receptor,Ca Release Channel Ryanodine Receptor,Calcium Ryanodine Receptor Complex,Complex, Calcium-Ryanodine Receptor,Receptor 1, Ryanodine,Receptor 2, Ryanodine,Receptor 3, Ryanodine,Receptor Complex, Calcium-Ryanodine,Receptors, Ryanodine

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