ArticleJournal of the American Heart Association2015
Use of whole exome sequencing for the identification of Ito-based arrhythmia mechanism and therapy.
Article in Journal of the American Heart Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 17 citations in OpenAlex.
- Ventricular arrhythmias involving the His-Purkinje system in the structurally abnormal heart.Pacing and clinical electrophysiology : PACE · 2018Review
- Purkinje physiology and pathophysiology.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2018Review
- Differential Expression and Remodeling of Transient Outward Potassium Currents in Human Left Ventricles.Circulation. Arrhythmia and electrophysiology · 2018Article
- Treat the Patient, Not Just the Cell!Circulation research · 2017Review
- Integrated Genomic Medicine: A Paradigm for Rare Diseases and Beyond.Advances in genetics · 2017Review
- Cardiac Purkinje fibers and arrhythmias; The GK Moe Award Lecture 2015.Heart rhythm · 2016Article
- Genetics of Common Endocrine Disease: The Present and the Future.The Journal of clinical endocrinology and metabolism · 2016Review
- From whole exome sequencing to patient-specific therapy: another example of how basic research pays off in patient care.Journal of the American Heart Association · 2015Article
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Authors and funding
16 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIdentified genetic variants are insufficient to explain all cases of inherited arrhythmia. We tested whether the integration of whole exome sequencing with well-established clinical, translational, and basic science platforms could provide rapid and novel insight into human arrhythmia pathophysiology and disease treatment. METHODS AND
resultsWe report a proband with recurrent ventricular fibrillation, resistant to standard therapeutic interventions. Using whole-exome sequencing, we identified a variant in a previously unidentified exon of the dipeptidyl aminopeptidase-like protein-6 (DPP6) gene. This variant is the first identified coding mutation in DPP6 and augments cardiac repolarizing current (Ito) causing pathological changes in Ito and action potential morphology. We designed a therapeutic regimen incorporating dalfampridine to target Ito. Dalfampridine, approved for multiple sclerosis, normalized the ECG and reduced arrhythmia burden in the proband by >90-fold. This was combined with cilostazol to accelerate the heart rate to minimize the reverse-rate dependence of augmented Ito.
conclusionsWe describe a novel arrhythmia mechanism and therapeutic approach to ameliorate the disease. Specifically, we identify the first coding variant of DPP6 in human ventricular fibrillation. These findings illustrate the power of genetic approaches for the elucidation and treatment of disease when carefully integrated with clinical and basic/translational research teams.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.