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

• DOI: 10.1038/gim.2014.91
• Publication Date: 2014-08-07T15:18:06Z
• Authors: Linnea M. Baudhuin; Katrina E. Kotzer; Susan A. Lagerstedt
• Keywords: Adult; Male; 0303 health sciences; Adolescent; Fibrillin-1; Microfilament Proteins; Middle Aged; Fibrillins; White People; Arabs; Marfan Syndrome; Black or African American; Alternative Splicing; Young Adult; 03 medical and health sciences; Mutation; Humans; Female; Aorta; Aged

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