{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:26:30Z","timestamp":1792715190615,"version":"4.5.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Genomic and Precision Medicine"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Pathogenic and likely pathogenic variants associated with arrhythmogenic right ventricular cardiomyopathy (ARVC), dilated cardiomyopathy (DCM), and hypertrophic cardiomyopathy (HCM) are recommended to be reported as secondary findings in genome sequencing studies. This provides opportunities for early diagnosis, but also fuels uncertainty in variant carriers (G+), since disease penetrance is incomplete. We assessed the prevalence and disease expression of G+ in the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We identified pathogenic and likely pathogenic variants associated with ARVC, DCM and\/or HCM in 200 643 UK Biobank individuals, who underwent whole exome sequencing. We calculated the prevalence of G+ and analyzed the frequency of cardiomyopathy\/heart failure diagnosis. In undiagnosed individuals, we analyzed early signs of disease expression using available electrocardiography and cardiac magnetic resonance imaging data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We found a prevalence of 1:578, 1:251, and 1:149 for pathogenic and likely pathogenic variants associated with ARVC, DCM and HCM respectively. Compared with controls, cardiovascular mortality was higher in DCM G+ (odds ratio 1.67 [95% CI 1.04; 2.59],\n                      <jats:italic>P<\/jats:italic>\n                      =0.030), but similar in ARVC and HCM G+ (\n                      <jats:italic>P<\/jats:italic>\n                      \u22650.100). Cardiomyopathy or heart failure diagnosis were more frequent in DCM G+ (odds ratio 3.66 [95% CI 2.24; 5.81],\n                      <jats:italic>P<\/jats:italic>\n                      =4.9\u00d710\n                      <jats:sup>\u22127<\/jats:sup>\n                      ) and HCM G+ (odds ratio 3.03 [95% CI 1.98; 4.56],\n                      <jats:italic>P<\/jats:italic>\n                      =5.8\u00d710\n                      <jats:sup>\u22127<\/jats:sup>\n                      ), but comparable in ARVC G+ (\n                      <jats:italic>P<\/jats:italic>\n                      =0.172). In contrast, ARVC G+ had more ventricular arrhythmias (\n                      <jats:italic>P<\/jats:italic>\n                      =3.3\u00d710\n                      <jats:sup>\u22124<\/jats:sup>\n                      ). In undiagnosed individuals, left ventricular ejection fraction was reduced in DCM G+ (\n                      <jats:italic>P<\/jats:italic>\n                      =0.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In the general population, pathogenic and likely pathogenic variants associated with ARVC, DCM, or HCM are not uncommon. Although G+ have increased mortality and morbidity, disease penetrance in these carriers from the general population remains low (1.2\u20133.1%). Follow-up decisions in case of incidental findings should not be based solely on a variant, but on multiple factors, including family history and disease expression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circgen.122.003704","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T11:51:36Z","timestamp":1666266696000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":73,"title":["Prevalence and Disease Expression of Pathogenic and Likely Pathogenic Variants Associated With Inherited Cardiomyopathies in the General Population"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6634-1989","authenticated-orcid":true,"given":"Mimount","family":"Bourfiss","sequence":"first","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6634-1989","authenticated-orcid":true,"given":"Marion","family":"van Vugt","sequence":"additional","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1450-2936","authenticated-orcid":true,"given":"Abdulrahman I.","family":"Alasiri","sequence":"additional","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-5709","authenticated-orcid":true,"given":"Bram","family":"Ruijsink","sequence":"additional","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."},{"name":"School of Biomedical Engineering &amp; Imaging Sciences, King\u2019s College London, London, United Kingdom (B.R., E.P.-A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4934-7510","authenticated-orcid":true,"given":"Jessica","family":"van Setten","sequence":"additional","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1327-0424","authenticated-orcid":true,"given":"A. Floriaan","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."},{"name":"Faculty of Population Health Sciences Institute of Cardiovascular Science, London, London, United Kingdom (A.F.S., F.W.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Dooijes","sequence":"additional","affiliation":[{"name":"Dept of Genetics, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (D.D., J.P.v.T., A.F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9789-6629","authenticated-orcid":true,"given":"Esther","family":"Puyol-Ant\u00f3n","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering &amp; Imaging Sciences, King\u2019s College London, London, United Kingdom (B.R., E.P.-A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2542-9474","authenticated-orcid":true,"given":"Birgitta K.","family":"Velthuis","sequence":"additional","affiliation":[{"name":"Dept of Radiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (B.K.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3854-6749","authenticated-orcid":true,"given":"J. Peter","family":"van Tintelen","sequence":"additional","affiliation":[{"name":"Dept of Genetics, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (D.D., J.P.v.T., A.F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6634-1989","authenticated-orcid":true,"given":"Anneline S.J.M.","family":"te Riele","sequence":"additional","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."},{"name":"Netherlands Heart Institute, Utrecht, the Netherlands (A.S.J.M.t.R)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0335-9452","authenticated-orcid":true,"given":"Annette F.","family":"Baas","sequence":"additional","affiliation":[{"name":"Dept of Genetics, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (D.D., J.P.v.T., A.F.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1692-8669","authenticated-orcid":true,"given":"Folkert W.","family":"Asselbergs","sequence":"additional","affiliation":[{"name":"Dept of Cardiology, Univ Medical Center Utrecht, Utrecht Univ, Utrecht, the Netherlands (M.B., M.v.V., A.I.A., A.S.J.M.t.R., B.R., J.v.S., A.F.S., F.W.A.)."},{"name":"Faculty of Population Health Sciences Institute of Cardiovascular Science, London, London, United Kingdom (A.F.S., F.W.A.)."},{"name":"Health Data Research UK &amp; 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