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

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 vascu...

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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
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container_title European heart journal
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creator 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
description 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
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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&lt;0.001) (Figure). Time to death or lung transplantation Conclusions PAH patients with the RNF213 p.Arg4810Lys variant were associated with a poor reactivity to vasodilator drugs and poor clinical outcomes even in the recent era. Earlier consideration of lung transplantation might be required for RNF213 p.Arg4810Lys variant carriers developing PAH. Documentation of the RNF213 p.Arg4810Lys variant, as well as already known pathogenic genes, can provide clinically relevant information for therapeutic strategies, leading to a personalized approach for the treatment of PAH.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz746.0729</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Hiraide, T</creatorcontrib><creatorcontrib>Kataoka, M</creatorcontrib><creatorcontrib>Suzuki, H</creatorcontrib><creatorcontrib>Aimi, Y</creatorcontrib><creatorcontrib>Chiba, T</creatorcontrib><creatorcontrib>Isobe, S</creatorcontrib><creatorcontrib>Katsumata, Y</creatorcontrib><creatorcontrib>Goto, S</creatorcontrib><creatorcontrib>Kanekura, K</creatorcontrib><creatorcontrib>Satoh, T</creatorcontrib><creatorcontrib>Sano, M</creatorcontrib><creatorcontrib>Gamou, S</creatorcontrib><creatorcontrib>Kosaki, K</creatorcontrib><creatorcontrib>Fukuda, K</creatorcontrib><title>P6009Poor outcomes in pulmonary arterial hypertension as a member of RNF213-associated vascular diseases</title><title>European heart journal</title><description>Abstract Background A variant of c.14429G&gt;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&lt;0.001) (Figure). Time to death or lung transplantation Conclusions PAH patients with the RNF213 p.Arg4810Lys variant were associated with a poor reactivity to vasodilator drugs and poor clinical outcomes even in the recent era. Earlier consideration of lung transplantation might be required for RNF213 p.Arg4810Lys variant carriers developing PAH. Documentation of the RNF213 p.Arg4810Lys variant, as well as already known pathogenic genes, can provide clinically relevant information for therapeutic strategies, leading to a personalized approach for the treatment of PAH.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkN1Kw0AQRhdRsFYfQdgXSDu7m-zPpRSrhaJFeuFd2GwmJCXJht1GqE9vSsVrr-Zj4HzMHEIeGSwYGLHEMdRow_GwxPpbpXIBipsrMmMZ54mRaXZNZsBMlkipP2_JXYwHANCSyRmpdxLA7LwP1I9H5zuMtOnpMLad72040akXQ2NbWp8GnHIfG99TG6mlHXYFTlxFP97WnInExuhdY49Y0i8b3djaQMsmoo0Y78lNZduID79zTvbr5_3qNdm-v2xWT9vEaWUSl1pVpRrQTRdyVXDDtBJGqWkNXOuCpbyAAiqDRnAAazXq0jghZSVKrsScZJdaF3yMAat8CE03PZIzyM-28j9b-cVWfrY1cXDh_Dj8E_kBDD9ytg</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Hiraide, T</creator><creator>Kataoka, M</creator><creator>Suzuki, H</creator><creator>Aimi, Y</creator><creator>Chiba, T</creator><creator>Isobe, S</creator><creator>Katsumata, Y</creator><creator>Goto, S</creator><creator>Kanekura, K</creator><creator>Satoh, T</creator><creator>Sano, M</creator><creator>Gamou, S</creator><creator>Kosaki, K</creator><creator>Fukuda, K</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P6009Poor outcomes in pulmonary arterial hypertension as a member of RNF213-associated vascular diseases</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c879-c4a7f480ec00027b291873977a7f0288b142b0b0f9e93200aa8e8d9c366f3d273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hiraide, T</creatorcontrib><creatorcontrib>Kataoka, M</creatorcontrib><creatorcontrib>Suzuki, H</creatorcontrib><creatorcontrib>Aimi, Y</creatorcontrib><creatorcontrib>Chiba, T</creatorcontrib><creatorcontrib>Isobe, S</creatorcontrib><creatorcontrib>Katsumata, Y</creatorcontrib><creatorcontrib>Goto, S</creatorcontrib><creatorcontrib>Kanekura, K</creatorcontrib><creatorcontrib>Satoh, T</creatorcontrib><creatorcontrib>Sano, M</creatorcontrib><creatorcontrib>Gamou, S</creatorcontrib><creatorcontrib>Kosaki, K</creatorcontrib><creatorcontrib>Fukuda, K</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hiraide, T</au><au>Kataoka, M</au><au>Suzuki, H</au><au>Aimi, Y</au><au>Chiba, T</au><au>Isobe, S</au><au>Katsumata, Y</au><au>Goto, S</au><au>Kanekura, K</au><au>Satoh, T</au><au>Sano, M</au><au>Gamou, S</au><au>Kosaki, K</au><au>Fukuda, K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P6009Poor outcomes in pulmonary arterial hypertension as a member of RNF213-associated vascular diseases</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Background A variant of c.14429G&gt;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&lt;0.001) (Figure). Time to death or lung transplantation Conclusions PAH patients with the RNF213 p.Arg4810Lys variant were associated with a poor reactivity to vasodilator drugs and poor clinical outcomes even in the recent era. Earlier consideration of lung transplantation might be required for RNF213 p.Arg4810Lys variant carriers developing PAH. Documentation of the RNF213 p.Arg4810Lys variant, as well as already known pathogenic genes, can provide clinically relevant information for therapeutic strategies, leading to a personalized approach for the treatment of PAH.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz746.0729</doi></addata></record>
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