Haplotype-Sharing Analysis Implicates Chromosome 7q36 Harboring DPP6 in Familial Idiopathic Ventricular Fibrillation  Marielle Alders, Tamara T. Koopmann,

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Haplotype-Sharing Analysis Implicates Chromosome 7q36 Harboring DPP6 in Familial Idiopathic Ventricular Fibrillation  Marielle Alders, Tamara T. Koopmann, Imke Christiaans, Pieter G. Postema, Leander Beekman, Michael W.T. Tanck, Katja Zeppenfeld, Peter Loh, Karel T. Koch, Sophie Demolombe, Marcel M.A.M. Mannens, Connie R. Bezzina, Arthur A.M. Wilde  The American Journal of Human Genetics  Volume 84, Issue 4, Pages 468-476 (April 2009) DOI: 10.1016/j.ajhg.2009.02.009 Copyright © 2009 The American Society of Human Genetics Terms and Conditions

Figure 1 Pedigrees of the Three IVF Families Used for the Haplotype-Sharing Analysis Affected subjects (SCD or resuscitated after IVF) are shown as filled circles (females) or squares (males). A slash indicates that the subject is deceased, and a dot indicates obligate carrier. The numbers after SCD or IVF indicate the age of the subject at the time of the event. Individuals included in the analysis are indicated with an arrow. Numbers inside symbols indicate the number of individuals present of that sex and status; for example, individual B-1 has four unaffected sisters. The American Journal of Human Genetics 2009 84, 468-476DOI: (10.1016/j.ajhg.2009.02.009) Copyright © 2009 The American Society of Human Genetics Terms and Conditions

Figure 2 Mapping of the IVF Locus (A) Result of the haplotype-sharing analysis. The length of the shared segment in number of SNPs is plotted, and the largest shared haplotype, of 301 contiguous SNPs on chromosome 7q36, is indicated by an arrow. (B) Shared 7q36 chromosomal region, discovered after initial haplotype-sharing analysis and after extended haplotyping in additional families. The position of the markers and genes (in Mb) is shown, according to the human genome build 36.3. Isoforms 1, 2, and 3 of DPP6 are also known as isoforms L, S, and K, respectively. Only validated genes are indicated. The American Journal of Human Genetics 2009 84, 468-476DOI: (10.1016/j.ajhg.2009.02.009) Copyright © 2009 The American Society of Human Genetics Terms and Conditions

Figure 3 Haplotypes in the Ten IVF Families Haplotype analysis in the ten families (A to J) with the risk haplotype. Probands are labeled −1. Affected subjects (SCD or resuscitated after IVF) are shown as filled circles (females) or squares (males). A slash indicates that the subject is deceased, and a dot indicates an obligate carrier. Individuals included in the haplotype-sharing analysis are indicated (B-1, A-1, A-2, C-1), as well as individuals from whom a cardiac biopsy was used for expression studies (A-2, B-1, H-2, I-1, and J-1). The risk haplotype is colored black. Families E, G, H, and I carry recombinants, which are indicated with an arrow. The smallest shared segment, based on these recombinations, is indicated with a black bar next to the haplotype. From individuals labeled with an asterisk, DNA was extracted from paraffin-embedded tissues, and the haplotypes of individuals labeled with a “+” were inferred from their children. The American Journal of Human Genetics 2009 84, 468-476DOI: (10.1016/j.ajhg.2009.02.009) Copyright © 2009 The American Society of Human Genetics Terms and Conditions

Figure 4 Expression Analysis of the DPP6 Gene (A) Reverse Transcriptase PCR on biopsies of three patients heterozygous for SNP rs3807218. The contribution of the A allele, which is on the risk haplotype, is increased relative to that of the G allele. (B) DPP6 mRNA expression in cardiac biopsies from affected individuals, relative to HPRT expression. The quantification of all DPP6 isoforms with primers in exon 6 and 8 was performed on five patient samples, and isoform-specific analysis was performed on two patient samples. Bars represent standard errors. The American Journal of Human Genetics 2009 84, 468-476DOI: (10.1016/j.ajhg.2009.02.009) Copyright © 2009 The American Society of Human Genetics Terms and Conditions

Figure 5 A 12-Lead ECG Recording of a Resuscitated Male No specific conduction or repolarization abnormalities are observed. Regular sinus rhythm is disturbed by spontaneous monomorphic extrasystoles (indicated with an asterisk) with a short coupling interval, a left bundle branch block morphology, and a superior axis. The fourth extrasystole initiates ventricular fibrillation, for which defibrillation was required (not shown). The American Journal of Human Genetics 2009 84, 468-476DOI: (10.1016/j.ajhg.2009.02.009) Copyright © 2009 The American Society of Human Genetics Terms and Conditions

Figure 6 Survival The survival curve of risk-haplotype carriers (black) and noncarriers (gray), demonstrating a median survival of 58 years for individuals carrying the high-risk haplotype. The American Journal of Human Genetics 2009 84, 468-476DOI: (10.1016/j.ajhg.2009.02.009) Copyright © 2009 The American Society of Human Genetics Terms and Conditions