Increased frequency of FBN1 truncating and splicing variants in Marfan syndrome patients with aortic events

Genet Med. 2015 Mar;17(3):177-87. doi: 10.1038/gim.2014.91. Epub 2014 Aug 7.

Abstract

Purpose: Marfan syndrome is a systemic disorder that typically involves FBN1 mutations and cardiovascular manifestations. We investigated FBN1 genotype-phenotype correlations with aortic events (aortic dissection and prophylactic aortic surgery) in patients with Marfan syndrome.

Methods: Genotype and phenotype information from probands (n = 179) with an FBN1 pathogenic or likely pathogenic variant were assessed.

Results: A higher frequency of truncating or splicing FBN1 variants was observed in Ghent criteria-positive patients with an aortic event (n = 34) as compared with all other probands (n = 145) without a reported aortic event (79 vs. 39%; P < 0.0001), as well as Ghent criteria-positive probands (n = 54) without an aortic event (79 vs. 48%; P = 0.0039). Most probands with an early aortic event had a truncating or splicing variant (100% (n = 12) and 95% (n = 21) of patients younger than 30 and 40 years old, respectively). Aortic events occurred at a younger median age in patients with truncating/splicing variants (29 years) as compared with those with missense variants (51 years). A trend toward a higher frequency of truncating/splicing variants in patients with aortic dissection (n = 21) versus prophylactic surgery (n = 13) (85.7 vs. 69.3%; not significant) was observed.

Conclusion: These aortic event- and age-associated findings may have important implications for the management of Marfan syndrome patients with FBN1 truncating and splicing variants.Genet Med 17 3, 177-187.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / genetics
  • Aged
  • Alternative Splicing*
  • Aorta / pathology
  • Aorta / surgery*
  • Arabs / genetics
  • Female
  • Fibrillin-1
  • Fibrillins
  • Humans
  • Male
  • Marfan Syndrome / ethnology
  • Marfan Syndrome / genetics*
  • Marfan Syndrome / pathology*
  • Marfan Syndrome / surgery
  • Microfilament Proteins / genetics*
  • Middle Aged
  • Mutation
  • Whites / genetics
  • Young Adult

Substances

  • FBN1 protein, human
  • Fibrillin-1
  • Fibrillins
  • Microfilament Proteins