Genome-wide association study reveals novel genetic loci: a new polygenic risk score for mitral valve prolapse

European Heart Journal

4 March 2022
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ESC Journals BASIC SCIENCE

Abstract

AbstractAims

Mitral valve prolapse (MVP) is a common valvular heart disease with a prevalence of >2% in the general adult population. Despite this high incidence, there is a limited understanding of the molecular mechanism of this disease, and no medical therapy is available for this disease. We aimed to elucidate the genetic basis of MVP in order to better understand this complex disorder.

Methods and results

We performed a meta-analysis of six genome-wide association studies that included 4884 cases and 434 649 controls. We identified 14 loci associated with MVP in our primary analysis and 2 additional loci associated with a subset of the samples that additionally underwent mitral valve surgery. Integration of epigenetic, transcriptional, and proteomic data identified candidate MVP genes including LMCD1, SPTBN1, LTBP2, TGFB2, NMB, and ALPK3. We created a polygenic risk score (PRS) for MVP and showed an improved MVP risk prediction beyond age, sex, and clinical risk factors.

Conclusion

We identified 14 genetic loci that are associated with MVP. Multiple analyses identified candidate genes including two transforming growth factor-β signalling molecules and spectrin β. We present the first PRS for MVP that could eventually aid risk stratification of patients for MVP screening in a clinical setting. These findings advance our understanding of this common valvular heart disease and may reveal novel therapeutic targets for intervention.

Contributors

Jacob Tfelt-Hansen
Jacob Tfelt-Hansen

Author

Rigshospitalet - Copenhagen University Hospital Copenhagen , Denmark

Michiel Rienstra
Michiel Rienstra

Author

University Medical Centre Groningen Groningen , Netherlands (The)

Giovanni Benfari
Giovanni Benfari

Author

University of Verona Verona , Italy

Maurice Enriquez-Sarano
Maurice Enriquez-Sarano

Author

Minneapolis Heart Institute Foundation Minneapolis , United States of America

Nabila Bouatia-Naji
Nabila Bouatia-Naji

Author

National Institute of Health and Medical Research (INSERM home) Paris , France

Patrick T Ellinor
Patrick T Ellinor

Author

Leducq Foundation for Cardiovascular Research Boston , United States of America

David J Milan
David J Milan

Author

Leducq Foundation for Cardiovascular Research Boston , United States of America