P6009Poor outcomes in pulmonary arterial hypertension as a member of RNF213-associated vascular diseases

• Published in: European heart journal 2019-10, Vol.40 (Supplement_1)
• Main Authors: Hiraide, T, Kataoka, M, Suzuki, H, Aimi, Y, Chiba, T, Isobe, S, Katsumata, Y, Goto, S, Kanekura, K, Satoh, T, Sano, M, Gamou, S, Kosaki, K, Fukuda, K
• Format: Article
• Language: English
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehz746.0729

Abstract Background A variant of c.14429G>A (p.Arg4810Lys, rs112735431) in the ring finger protein 213 gene (RNF213; NM_001256071.2) has been recently identified as a risk allele for pulmonary arterial hypertension (PAH), suggesting that PAH can be added as a new member of RNF213-associated vascular diseases including Moyamoya disease and peripheral pulmonary stenosis. Purpose Our aim was to identify the clinical features and outcomes of PAH patients with RNF213 p.Arg4810Lys variant. Methods Whole-exome sequencing was performed in 139 idiopathic (or possibly heritable) PAH patients. Hemodynamics and prognosis were evaluated in the patients with RNF213 p.Arg4810Lys variant and the patients with bone morphogenic protein receptor type 2 (BMPR2) mutations. Results The RNF213 p.Arg4810Lys variant was identified in a heterozygous state in 11 patients (7.9%). Time-course changes in hemodynamics after combination therapy in the patients with the RNF213 p.Arg4810Lys variant were significantly poorer compared with those in BMPR2 mutation carriers (n=36) (comparison of changes in mean pulmonary arterial pressure, P=0.007). The event-free rate of death or lung transplantation was significantly poorer in RNF213 p.Arg4810Lys variant carriers than in BMPR2 mutation carriers (5-year event-free rate since the introduction of prostaglandin I2 infusion, 0% vs. 93%, P