Health behaviors among unaffected participants following receipt of variants of uncertain significance in cardiomyopathy-associated genes

Genet Med. 2019 Mar;21(3):748-752. doi: 10.1038/s41436-018-0083-8. Epub 2018 Jul 12.


Purpose: Studies on returning variants of uncertain significance (VUS) results have predominantly included patients with a personal or family history of cancer and cancer-associated gene VUS. This study examined health behaviors among participants with cardiomyopathy-associated gene VUS, but without a personal history of cardiomyopathy.

Methods: Sixty-eight eligible participants without apparent cardiomyopathy but with VUS in cardiomyopathy-associated genes completed a survey of health behaviors, disclosure, distress, uncertainty, positive experiences, decisional conflict, and perceived value. The medical records of participants who reported cardiac testing because of their VUS were reviewed for testing indication(s).

Results: Two participants had cardiac testing due to their VUS alone. Four had cardiac testing because of their VUS and other clinical indications. Twelve changed health behaviors, including one participant who was subsequently diagnosed with cardiomyopathy. Distress, uncertainty, and decisional conflict were low (means = 1.2, 4.2, and 24.5 (scale ranges = 0-30, 0-45, and 15-75), respectively), and positive experiences and perceived value were moderate (means = 12.4 and 14.4 (scale ranges = 0-20 and 4-20), respectively). Greater perceived value was associated with greater likelihood to engage in health behaviors (P = 0.04).

Conclusion: Positive VUS results can be returned to apparently unaffected individuals with modest use of healthcare resources, minimal behavioral changes, and favorable psychological reactions.

Keywords: Genome sequencing; Health behaviors; Healthcare use; Psychological reactions; Variants of uncertain significance.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics
  • Breast Neoplasms / genetics
  • Cardiomyopathies / genetics
  • Female
  • Genetic Counseling / psychology*
  • Genetic Predisposition to Disease
  • Genetic Testing / ethics*
  • Genetic Testing / methods
  • Genetic Variation / genetics
  • Health Behavior / ethics*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Middle Aged
  • Stress, Psychological
  • Surveys and Questionnaires
  • Uncertainty


  • BRCA1 Protein
  • BRCA2 Protein