Dilated & Arrhythmogenic Cardiomyopathy Sequencing Panel

Test Information

This panel of 51 genes is intended for patients with a diagnosis or clinical suspicion of Dilated & Arrhythmogenic Cardiomyopathy and is performed by Next Generation Sequencing (NGS).

Turnaround Time

8-10 weeks

CPT Code(s)

81439

Cost

$3,000

Genes

Clinical Information

Familial dilated cardiomyopathy (DCM) is associated with thinning of cardiac muscle, resulting in enlargement of the affected chamber(s). Reduced efficiency of cardiac blood flow causes progressive thinning which, untreated, may result in heart failure. Onset of symptoms typically occurs in adulthood, and these include arrhythmia, dyspnea, extreme fatigue, exercise intolerance, syncope, and swelling of the lower extremities. In some cases, sudden cardiac death in an undiagnosed or asymptomatic individual can occur.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) occurs when right ventricular tissue breaks down and is replaced by fat and scar tissue. Heart palpitations, syncope, and swelling of the legs can occur. In addition, cardiac arrest may be triggered by exercise, so sudden death in young athletes has been reported with this condition. Disease presentation is highly variable, even within families.

Treatments include pharmocologic therapies, implanted defibrillators, and in severe cases, heart transplant. While some types demonstrate autosomal recessive or X-linked inheritance, most forms are inherited in an autosomal dominant pattern. This panel consists of 51 genes that are associated with these conditions.

Indications

For patients with a specific suspected disorder, individual gene sequencing should be considered first.

Molecular testing is useful to confirm the diagnosis and to identify the disease causing mutations within a family to allow for carrier testing and prenatal diagnosis.

Methodology

Next Generation Sequencing

Detection

The current design of this panel covers all genes and the flanking intronic sequences. This method allows for analysis of greater than 98% of the targeted sequence for the detection of nucleotide substitutions and small deletions and duplications. Large deletions and duplications will not be detected by this panel. Mutations and variants identified on the panel are confirmed with Sanger sequencing. All novel and apparently pathogenic changes are reported when found within the coding region as well as within 10 basepairs of each intron/exon boundary for each gene. Promoter and 3' untranslated sequences are not included in the current analysis. It should be noted that the current protocol is not specifically designed to detect copy number alterations and single exon deletions may require additional follow-up to determine whether or not they represent technical artifacts.

We recommend further array-based testing to more accurately address the concerns of dosage alterations. The Cytogenetic Laboratory at GGC offers a high resolution whole genome SNP microarray. The GGC Diagnostic Laboratory Directors are available for further consultation regarding the limitations of the NGS and array testing procedures.

Specimen Requirements

5 to 7 ml of peripheral blood collected in an EDTA (lavender top) tube is the preferred specimen type. The minimal blood needed for reliable DNA isolation is 3 ml. Extracted DNA is also accepted for this test.

Transport Instructions

The specimen should be kept at room temperature and delivered via overnight shipping. If shipment is delayed by one or two days, the specimen should be refrigerated and shipped at room temperature. Do not freeze the specimen. Samples collected on Friday can be safely designated for Monday delivery.

Prenatal Testing Information

If the pathogenic mutation(s) are identified in an affected individual using this panel, prenatal diagnosis is available for future pregnancies. Sanger sequencing will be used for prenatal diagnosis when there is a known familial mutation. Additional fees for cell culture and maternal cell contamination may apply. Maternal cell contamination studies are required for all prenatal molecular tests. Contact the laboratory prior to sending a prenatal specimen.

Have Questions Need Support?

Call our laboratory at 1-800-473-9411 or contact one of our Laboratory Genetic Counselors for assistance.
Robin Fletcher, MS, CGC
Kellie Walden, MS, CGC

Molecular Testing, NGS Panel, NGS Panels
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