Aorta Panel

SEQmethod-seq-icon Our Sequence Analysis is based on a proprietary targeted sequencing method OS-Seq™ and offers panels targeted for genes associated with certain phenotypes. A standard way to analyze NGS data for finding the genetic cause for Mendelian disorders. Results in 21 days. DEL/DUPmethod-dup-icon Targeted Del/Dup (CNV) analysis is used to detect bigger disease causing deletions or duplications from the disease-associated genes. Results in 21 days. PLUSmethod-plus-icon Plus Analysis combines Sequence + Del/Dup (CNV) Analysis providing increased diagnostic yield in certain clinical conditions, where the underlying genetic defect may be detectable by either of the analysis methods. Results in 21 days.

Test code: CA1001

The Blueprint Genetics Aorta Panel is a 37 gene test for genetic diagnostics of patients with clinical diagnosis of aortic disease. This typically includes aorta aneurysms and/or aorta dissection.

Majority of non-syndromic and syndromic aortic aneurysm diseases are inherited in autosomal dominant manner. Recessive inheritance is also described in some sydromic forms of the diease. Genetic diagnostics is an important part of differential diagnostics and risk stratification of the disease. Undisputed evidence shows that aortic aneurysm diseases advance with variable progression rate depending on the underlying cause. Genetic diagnostics has an increasing role in determining timing of interventions. Genetic diagnosis also enables efficient screening of first-degree relatives and identification of family members at higher risk for catastrophic complications of aortic aneurysm diseases. The Aorta Panel covers both non-syndromic and syndromic aortic diseases.

About aortic disease

Aortic dilatation is defined by a diameter larger than 110% of reference value determined by age, sex, and body surface area. Progressing aortic dilatation eventually fulfills the definition of aortic aneurysm, which is a local aortic diameter higher than 150% of reference value. Usually aortic aneurysm formation is driven by reduced elastin content and it’s fragmentation with concomitant smooth muscle cell loss, a process called cystic medial degeneration. Although this process is seen normally as a consequence of aging, it is accelerated in aortic aneurysm diseases. Most of the aortic aneurysms associate to non-syndromic dilatation. However, at least 20% of aortic aneurysms are in context of syndromic diseases such as Marfan syndrome (MfS), Loeys-Dietz syndrome (LDS), Shprintzen-Goldberg syndrome (SGS) and vascular and other Ehlers-Danlos syndromes (EDS). Aortic aneurysms lead frequently to sudden cardiac death due to rupture and dissection that may also rarely exist without earlier aneurysm or dilatation.

Availability

Results in 3-4 weeks.

Genes in the Aorta Panel and their clinical significance
GeneAssociated phenotypesInheritanceClinVarHGMD
ABCC6*Pseudoxanthoma elasticumAD/AR/Digenic39285
ACTA2Aortic aneurysm, familial thoracic, Moyamoya disease, Multisystemic smooth muscle dysfunction syndromeAD2170
ADAMTS2Ehlers-Danlos syndromeAR311
CBSHomocystinuria due to cystathionine beta-synthase deficiencyAR51192
COL1A1Ehlers-Danlos syndrome, Osteogenesis imperfectaAD120883
COL1A2Ehlers-Danlos syndrome, cardiac valvular form, Osteogenesis imperfectaAD79473
COL2A1Avascular necrosis of femoral head, Stickler syndrome, Rhegmatogenous retinal detachment, Epiphyseal dysplasia, with myopia and deafness, Czech dysplasiaAD106537
COL3A1Ehlers-Danlos syndromeAD452617
COL5A1Ehlers-Danlos syndromeAD43133
COL5A2Ehlers-Danlos syndromeAD1223
COL9A1Stickler syndromeAR34
COL9A2Stickler syndromeAR512
COL11A1Marshall syndrome, Fibrochondrogenesis, Stickler syndromeAD/AR1876
COL18A1Knobloch syndromeAR1329
EFEMP2Cutis laxaAR1115
ELNCutis laxa, Supravalvular aortic stenosisAD67104
ENPP1Arterial calcification, Hypophosphatemic ricketsAR1772
FBLN5Cutis laxa, Macular degeneration, age-relatedAD/AR1321
FBN1MASS syndrome, Shprintzen-Goldberg syndrome, Marfan syndromeAD5192056
FBN2Congenital contractural arachnodactyly (Beals syndrome)AD3085
FKBP14Ehlers-Danlos syndrome with progressive kyphoscoliosis, myopathy, and hearing lossAR44
FLNAIntestinal pseudoobstruction, neuronal/Congenital short bowel syndrome, Heterotopia, periventricular, Ehlers-Danlos variant, Cardiac valvular dysplasiaXL86209
GATA5Familial atrial fibrillation, Tetralogy of Fallot, Single ventricular septal defectAD/AR27
MFAP5Aortic aneurysm, familial thoracicAD23
MYH11Aortic aneurysm, familial thoracicAD1545
NOTCH1Aortic valve diseaseAD2872
PLOD1Ehlers-Danlos syndromeAR1637
SKIShprintzen-Goldberg syndromeAD1520
SLC2A10Arterial tortuosity syndromeAR2130
SLC39A13Spondylocheirodysplasia, Ehlers-Danlos syndrome-likeAR27
SMAD3Aneurysms-osteoarthritis syndrome, Loeys-Dietz syndromeAD2650
TGFB2Loeys-Dietz syndromeAD1524
TGFB3Loeys-Dietz syndrome (Reinhoff syndrome), Arrhythmogenic right ventricular dysplasiaAD818
TGFBR1Loeys-Dietz syndromeAD2567
TGFBR2Loeys-Dietz syndromeAD54130
TNXB*Ehlers-Danlos syndromeAR826
ZNF469Brittle cornea syndromeAR3135
  • * Some regions of the gene are duplicated in the genome leading to limited sensitivity within the regions. Thus, low-quality variants are filtered out from the duplicated regions and only high-quality variants confirmed by other methods are reported out. Read more.

Gene, refers to HGNC approved gene symbol; Inheritance to inheritance patterns such as autosomal dominant (AD), autosomal recessive (AR) and X-linked (XL); ClinVar, refers to a number of variants in the gene classified as pathogenic or likely pathogenic in ClinVar (http://www.ncbi.nlm.nih.gov/clinvar/); HGMD, refers to a number of variants with possible disease association in the gene listed in Human Gene Mutation Database (HGMD, http://www.hgmd.cf.ac.uk/ac/). The list of associated (gene specific) phenotypes are generated from CDG (http://research.nhgri.nih.gov/CGD/) or Orphanet (http://www.orpha.net/) databases.

Blueprint Genetics offers a comprehensive aorta panel that covers classical genes associated with aortic anaurysm, ruptured, abdominal aorta, aortic aneurysm, ruptured, thracic aorta, aortic aneurysm, ruptured, unspecific site, aortic aneurysm, thoracic aorta, aortic disection, thorcic aorta, arterial tortuosity syndrome, congenital contractural arachnodactyly, Ehlers-Danlos syndrome, Loeys-Dietz syndrome, Marfan syndrome and Shprintzen-Goldberg syndrome. The genes are carefully selected based on the existing scientific evidence, our experience and most current mutation databases. Candidate genes are excluded from this first-line diagnostic test. The test does not recognise balanced translocations or complex inversions, and it may not detect low-level mosaicism. The test should not be used for analysis of sequence repeats or for diagnosis of disorders caused by mutations in the mitochondrial DNA.

Please see our latest validation report showing sensitivity and specificity for SNPs and indels, sequencing depth, % of the nucleotides reached at least 15x coverage etc. If the Panel is not present in the report, data will be published when the Panel becomes available for ordering. Analytical validation is a continuous process at Blueprint Genetics. Our mission is to improve the quality of the sequencing process and each modification is followed by our standardized validation process. All the Panels available for ordering have sensitivity and specificity higher than > 0.99 to detect single nucleotide polymorphisms and a high sensitivity for indels ranging 1-19 bp. The diagnostic yield varies substantially depending on the used assay, referring healthcare professional, hospital and country. Blueprint Genetics’ Plus Analysis (Seq+Del/Dup) maximizes the chance to find molecular genetic diagnosis for your patient although Sequence Analysis or Del/Dup Analysis may be cost-effective first line test if your patient’s phenotype is suggestive for a specific mutation profile. Detection limit for Del/Dup analysis varies through the genome from one to six exon Del/Dups depending on exon size, sequencing coverage and sequence content.

The sequencing data generated in our laboratory is analyzed with our proprietary data analysis and annotation pipeline, integrating state-of-the art algorithms and industry-standard software solutions. Incorporation of rigorous quality control steps throughout the workflow of the pipeline ensures the consistency, validity and accuracy of results. The highest relevance in the reported variants is achieved through elimination of false positive findings based on variability data for thousands of publicly available human reference sequences and validation against our in-house curated mutation database as well as the most current and relevant human mutation databases. Reference databases currently used are the 1000 Genomes Project (http://www.1000genomes.org), the NHLBI GO Exome Sequencing Project (ESP; http://evs.gs.washington.edu/EVS), the Exome Aggregation Consortium (ExAC; http://exac.broadinstitute.org), ClinVar database of genotype-phenotype associations (http://www.ncbi.nlm.nih.gov/clinvar) and the Human Gene Mutation Database (http://www.hgmd.cf.ac.uk). The consequence of variants in coding and splice regions are estimated using the following in silico variant prediction tools: SIFT (http://sift.jcvi.org), Polyphen (http://genetics.bwh.harvard.edu/pph2/), and Mutation Taster (http://www.mutationtaster.org).

Through our online ordering and statement reporting system, Nucleus, the customer can access specific details of the analysis of the patient. This includes coverage and quality specifications and other relevant information on the analysis. This represents our mission to build fully transparent diagnostics where the customer gains easy access to crucial details of the analysis process.

In addition to our cutting-edge patented sequencing technology and proprietary bioinformatics pipeline, we also provide the customers with the best-informed clinical report on the market. Clinical interpretation requires fundamental clinical and genetic understanding. At Blueprint Genetics our geneticists and clinicians, who together evaluate the results from the sequence analysis pipeline in the context of phenotype information provided in the requisition form, prepare the clinical statement. Our goal is to provide clinically meaningful statements that are understandable for all medical professionals, even without training in genetics.

Variants reported in the statement are always classified using the Blueprint Genetics Variant Classification Scheme modified from the ACMG guidelines (Richards et al. 2015), which has been developed by evaluating existing literature, databases and with thousands of clinical cases analyzed in our laboratory. Variant classification forms the corner stone of clinical interpretation and following patient management decisions. Our statement also includes allele frequencies in reference populations and in silico predictions. We also provide PubMed IDs to the articles or submission numbers to public databases that have been used in the interpretation of the detected variants. In our conclusion, we summarize all the existing information and provide our rationale for the classification of the variant.

A final component of the analysis is the Sanger confirmation of the variants classified as likely pathogenic or pathogenic. This does not only bring confidence to the results obtained by our NGS solution but establishes the mutation specific test for family members. Sanger sequencing is also used occasionally with other variants reported in the statement. In the case of variant of uncertain significance (VUS) we do not recommend risk stratification based on the genetic finding. Furthermore, in the case VUS we do not recommend use of genetic information in patient management or genetic counseling. For some cases Blueprint Genetics offers a special free of charge service to investigate the role of identified VUS.

We constantly follow genetic literature adapting new relevant information and findings to our diagnostics. Relevant novel discoveries can be rapidly translated and adopted into our diagnostics without delay. These processes ensure that our diagnostic panels and clinical statements remain the most up-to-date on the market.

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ICD & CPT codes

CPT codes

SEQ81410
DEL/DUP81479


ICD codes

Commonly used ICD-10 codes when ordering the Aorta Panel

ICD-10Disease
I71.00Aortic disection, thorcic aorta
I71.1Aortic aneurysm, ruptured, thracic aorta
I71.2Aortic aneurysm, thoracic aorta
I71.3Aortic anaurysm, ruptured, abdominal aorta
I71.8Aortic aneurysm, ruptured, unspecific site

Accepted sample types

  • EDTA blood, min. 1 ml
  • Purified DNA, min. 5μg
  • Saliva (Oragene DNA OG-500 kit)

Label the sample tube with your patient’s name, date of birth and the date of sample collection.

Note that we do not accept DNA samples isolated from formalin-fixed paraffin-embedded (FFPE) tissue.