{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:53:34Z","timestamp":1793134414624,"version":"4.5.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Studies have demonstrated that patients with myocarditis may have a higher burden of cardiomyopathy-associated genetic variants than the general population. However, data on children are limited. We compared the prevalence of rare predicted-damaging variants and clinically pathogenic variants in children with dilated cardiomyopathy (DCM) secondary to myocarditis with that in children with DCM alone and in heart-healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Children with DCM secondary to myocarditis and children with DCM alone who underwent exome sequencing as part of a prior cross-sectional study were identified in the Pediatric Cardiomyopathy Registry, a large multicenter registry of children with cardiomyopathy. Controls from the Indiana University Biobank were matched 4:1 with myocarditis cases on genomic similarity. Rare predicted-damaging variants in cardiomyopathy-associated genes were identified using a bioinformatics approach. Clinical guidelines were used to determine clinical pathogenicity. The prevalence of variants was compared across the 3 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      There were 32 patients with DCM secondary to myocarditis. The prevalence of rare predicted-damaging variants was 34.4% (11\/32 [95% CI, 18.6%\u201353.2%]) in cases compared with 6.3% (8\/128 [95% CI, 2.7%\u201311.9%]) in controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Clinical review indicated all rare predicted-damaging variants in cases were pathogenic (1\/12), likely pathogenic (3\/12), or variants of uncertain significance (8\/12), whereas most variants in controls were benign (2\/8) or likely benign (4\/8). The prevalence of pathogenic\/likely pathogenic variants in cases was 12.5% (95% CI, 3.5%\u201329.0%) compared with 0% (95% CI, 0%\u20132.3%) in controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.01). Rare predicted-damaging and clinically pathogenic\/likely pathogenic variant prevalence was not significantly different in children with DCM secondary to myocarditis and DCM without myocarditis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.17 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =1.00, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Children with DCM secondary to myocarditis had a higher burden of variants in cardiomyopathy-associated genes than that of heart-healthy controls. Larger studies will be needed to determine the utility of routine genetic testing in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.013104","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T10:00:26Z","timestamp":1764928826000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiomyopathy-Associated Pathogenic Variants in Pediatric Myocarditis: A Study From the Pediatric Cardiomyopathy Registry"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7941-5599","authenticated-orcid":true,"given":"Alicia M.","family":"Kamsheh","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Washington University School of Medicine, St. Louis, MO (A.M.K., C.E.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4714-0142","authenticated-orcid":true,"given":"Stephanie M.","family":"Ware","sequence":"additional","affiliation":[{"name":"Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis (S.M.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0985-5801","authenticated-orcid":true,"given":"Surbhi","family":"Bhatnagar","sequence":"additional","affiliation":[{"name":"Division of Biomedical Informatics, Cincinnati Children\u2019s Hospital Medical Center, OH (S.B., B.J.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8702-9946","authenticated-orcid":true,"given":"Lisa J.","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Human Genetics, Cincinnati Children\u2019s Hospital, OH (L.J.M.)."},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, OH (L.J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (T.M.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4182-2786","authenticated-orcid":true,"given":"Jeffrey A.","family":"Towbin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Tennessee Health Science Center, Le Bonheur Children\u2019s Hospital, Memphis (J.A.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4244-1563","authenticated-orcid":true,"given":"Paul F.","family":"Kantor","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Keck School of Medicine of USC, Children\u2019s Hospital Los Angeles, CA (P.F.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0935-6858","authenticated-orcid":true,"given":"Ashwin K.","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Primary Children\u2019s Hospital, Salt Lake City (A.K.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7026-3058","authenticated-orcid":true,"given":"Neha","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Mount Sinai Kravis Children\u2019s Hospital, Icahn School of Medicine, New York, NY (N.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9478-9388","authenticated-orcid":true,"given":"Jean A.","family":"Ballweg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Michigan State University College of Human Medicine, Helen DeVos Children\u2019s Hospital, Grand Rapids (J.A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7941-0947","authenticated-orcid":true,"given":"Steven D.","family":"Colan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, MA (S.D.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce J.","family":"Aronow","sequence":"additional","affiliation":[{"name":"Division of Biomedical Informatics, Cincinnati Children\u2019s Hospital Medical Center, OH (S.B., B.J.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-7337","authenticated-orcid":true,"given":"Charles E.","family":"Canter","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Cardiology, Washington University School of Medicine, St. Louis, MO (A.M.K., 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