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Clinical Heterogeneity of Pulmonary Arterial Hypertension Associated With Variants in TBX4

Abstract: Background: The knowledge of hereditary predisposition has changed our understanding of Pulmonary Arterial Hypertension. Genetic testing has been widely extended and the application of Pulmonary Arterial Hypertension specific gene panels has allowed its inclusion in the diagnostic workup and increase the diagnostic ratio compared to the traditional sequencing techniques. This is particularly important in the differential diagnosis between Pulmonary Arterial Hypertension and Pulmonary Venoocclusive Disease. Methods: Since November 2011, genetic testing is offered to all patients with idiopathic, hereditable and associated forms of Pulmonary Arterial Hypertension or Pulmonary Venoocclusive Disease included in the Spanish Registry of Pulmonary Arterial Hypertension. Herein, we present the clinical phenotype and prognosis of all Pulmonary Arterial Hypertension patients with disease-associated variants in TBX4. Results: Out of 579 adults and 45 children, we found in eight patients from seven families, disease-causing associated variants in TBX4. All adult patients had a moderate-severe reduction in diffusion capacity. However, we observed a wide spectrum of clinical presentations, including Pulmonary Venoocclusive Disease suspicion, interstitial lung disease, pulmonary vascular abnormalities and congenital heart disease. Conclusions: Genetic testing is now essential for a correct diagnosis work-up in Pulmonary Arterial Hypertension. TBX4-associated Pulmonary Arterial Hypertension has marked clinical heterogeneity. In this regard, a genetic study is extremely useful to obtain an accurate diagnosis and provide appropriate management.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: PLoS One . 2020 Apr 29;15(4):e0232216

Editorial: Public Library of Science

 Año de publicación: 2020

Nº de páginas: 23

Tipo de publicación: Artículo de Revista

 DOI: 10.1371/journal.pone.0232216

ISSN: 1932-6203

Url de la publicación: https://doi.org/10.1371/journal. pone.0232216

Autores/as

HERNANDEZ-GONZALEZ, IGNACIO

TENORIO, JAIR

PALOMINO-DOZA, JULIAN

MARTINEZ MEÑACA, AMAYA

MORALES RUIZ, RAFAEL

LAGO-DOCAMPO, MAURO

VALVERDE GOMEZ, MARÍA

ENGUITA VALLS, ANA BELÉN

PEREZ-OLIVARES, CARMEN

VALVERDE, DIANA

GIL CARBONELL, JOAN

GARRIDO-LESTACHE RODRÍGUEZ-MONTE, ELVIRA

CERRO, MARIA JESUS DEL

LAPUNZINA, PABLO

ESCRIBANO-SUBIAS, PILAR