Heart valves that leak or do not completely seal the heart chambers lead to an additional load on the heart. They occur in some people with age and some not. The question of whether there might be a predisposition for this was evident after two children in two blood-related families each have leaking heart valves. After examining the genetic material of the family members, the scientists were able to determine a loss of the ADAMTS19 gene in these children. In the subsequent mouse experiment, mice with a switched off ADAMTS19 gene also had leaking heart valves. Both the tissue structure of the heart valves and their interaction with blood pressure were disturbed. A transcription factor involved in gene expression showed increased activity and led to a pathological alteration of the cellular structure of the heart valves.
The diagnosis "leaking heart valves" can be repaired - often without surgery - by inserting a new valve with the help of a catheter. However, this procedure does not lead to complete repair. According to Professor Hitz: "...the new findings can be incorporated into new studies, which aim at positively influencing the control loop disturbed by the genetic defect". It could stop the destruction of the heart valves of the affected patients, which progresses with age.
Original publication: Wünnemann F, Ta-Shma A, Preuss C et al. Loss of ADAMTS19 causes progressive non-syndromic heart valve disease. Nat Genet (2019) DOI: 10.1038/s41588-019-0536-2
Contact: Prof. Marc-Phillip Hitz, Clinic for Congenital Heart Defects and Pediatric Cardiology, University Medical Center Schleswig-Holstein - Campus Kiel, Marc-Phillip.Hitz(at)uksh.de
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