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Int. J. Mol. Sci. 2014, 15(6), 9302-9313;

Rare Variants in Genes Encoding MuRF1 and MuRF2 Are Modifiers of Hypertrophic Cardiomyopathy

State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
Intensive Care Unit, China Meitan General Hospital, Beijing 100028, China
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Authors to whom correspondence should be addressed.
Received: 7 March 2014 / Revised: 23 April 2014 / Accepted: 30 April 2014 / Published: 26 May 2014
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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Modifier genes contribute to the diverse clinical manifestations of hypertrophic cardiomyopathy (HCM), but are still largely unknown. Muscle ring finger (MuRF) proteins are a class of muscle-specific ubiquitin E3-ligases that appear to modulate cardiac mass and function by regulating the ubiquitin-proteasome system. In this study we screened all the three members of the MuRF family, MuRF1, MuRF2 and MuRF3, in 594 unrelated HCM patients and 307 healthy controls by targeted resequencing. Identified rare variants were confirmed by capillary Sanger sequencing. The prevalence of rare variants in both MuRF1 and MuRF2 in HCM patients was higher than that in control subjects (MuRF1 13/594 (2.2%) vs. 1/307 (0.3%), p = 0.04; MuRF2 22/594 (3.7%) vs. 2/307 (0.7%); p = 0.007). Patients with rare variants in MuRF1 or MuRF2 were younger (p = 0.04) and had greater maximum left ventricular wall thickness (p = 0.006) than those without such variants. Mutations in genes encoding sarcomere proteins were present in 19 (55.9%) of the 34 HCM patients with rare variants in MuRF1 and MuRF2. These data strongly supported that rare variants in MuRF1 and MuRF2 are associated with higher penetrance and more severe clinical manifestations of HCM. The findings suggest that dysregulation of the ubiquitin-proteasome system contributes to the pathogenesis of HCM. View Full-Text
Keywords: hypertrophic cardiomyopathy; muscle ring finger protein; rare variant; modifier hypertrophic cardiomyopathy; muscle ring finger protein; rare variant; modifier
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Su, M.; Wang, J.; Kang, L.; Wang, Y.; Zou, Y.; Feng, X.; Wang, D.; Ahmad, F.; Zhou, X.; Hui, R.; Song, L. Rare Variants in Genes Encoding MuRF1 and MuRF2 Are Modifiers of Hypertrophic Cardiomyopathy. Int. J. Mol. Sci. 2014, 15, 9302-9313.

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