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Deciphering hypoplastic left heart syndrome (HLHS) pathogenesis is confounded by its genetic heterogeneity and oligogenic underpinnings. Whole genome sequences were analyzed by three independent strategies to identify HLHS gene candidates, ranked by variant, gene, and disease-level metrics. The findings suggest that common and rare alleles within unconventional myosin genes are associated with HLHS susceptibility. The identified candidateMYO18Bregulates cardiac sarcomerogenesis, supporting the hypothesis of intrinsic myogenic perturbation in arrested left heart development.
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