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Atrial fibrillation (AF) is a heritable, genetically heterogeneous disorder. To identify gene defects that cause or confer susceptibility to AF, a cohort of 268 unrelated patients with idiopathic forms of familial and sporadic AF was recruited. LMNA, encoding the nuclear membrane proteins, lamin A/C, was selected as a candidate gene for lone AF based on its established association with a syndrome of dilated cardiomyopathy, conduction system disease, and AF. Comprehensive mutation scanning identified only 1 potentially pathogenic mutation. In conclusion, LMNA mutations rarely cause lone AF and routine genetic testing of LMNA in these patients does not appear warranted.

Objectives We sought to determine the physiologic actions and potential therapeutic applications of mutant atrial natriuretic peptide (mANP). Background The cardiac hormone atrial natriuretic peptide (ANP) is a 28-amino acid (AA) peptide that consists of a 17-AA ring structure together with a 6-AA N-terminus and a 5-AA C-terminus. In a targeted scan for sequence variants within the human ANP gene, a mutation was identified that results in a 40-AA peptide consisting of native ANP(1-28)and a C-terminal extension of 12 AA. We have termed this peptide mutant ANP. Methods In vitro 3′,5′-cyclic guanosine monophosphate (cGMP) activation in response to mANP was studied in cultured human cardiac fibroblasts known to express natriuretic peptide receptor A. The cardiorenal and neurohumoral properties of mANP compared with ANP were assessed in vivo in normal dogs. Results We observed an incremental in vitro cGMP dose response with increasing concentrations of mANP. In vivo with high-dose mANP (33 pmol/kg/min), we observed significantly greater plasma cGMP activation, diuretic, natriuretic, glomerular filtration rate enhancing, renin-angiotensin-aldosterone system inhibiting, cardiac unloading, and blood pressure lowering properties when compared with native ANP. Low-dose mANP (2 pmol/kg/min) has natriuretic and diuretic properties without altering systemic hemodynamics compared with no natriuretic or diuretic response with low-dose native ANP. Conclusions These studies establish that mANP activates cGMP in vitro and exerts greater and more sustained natriuretic, diuretic, glomerular filtration rate, and renal blood flow enhancing actions than native ANP in vivo.

Diseases resulting from impaired ion channel function—channelopathies—are increasingly recognized pathologies in human cardiovascular medicine.1 Understanding the molecular basis of an ion channel disease has provided new opportunities for screening, early diagnosis, and therapy of these commonly life-threatening conditions. 2, 3 A case in point is the identification of molecular genetic defects in inwardly rectifying potassium (Kir, KCNJ) channels.

We identified a unique family with autosomal dominant heart disease variably expressed as restrictive cardiomyopathy (RCM), hypertrophic cardiomyopathy (HCM), and dilated cardiomyopathy (DCM), and sought to identify the molecular defect that triggered divergent remodeling pathways. Polymorphic DNA markers for nine sarcomeric genes for DCM and/or HCM were tested for segregation with disease. Linkage to eight genes was excluded, but a cardiac troponin T (TNNT2) marker cosegregated with the disease phenotype. Sequencing of TNNT2 identified a heterozygous missense mutation resulting in an I79N substitution, inherited by all nine affected family members but by none of the six unaffected relatives. Mutation carriers were diagnosed with RCM (n = 2), non-obstructive HCM (n = 3), DCM (n = 2), mixed cardiomyopathy (n = 1), and mild concentric left ventricular hypertrophy (n = 1). Endomyocardial biopsy in the proband revealed non-specific fibrosis, myocyte hypertrophy, and no myofibrillar disarray. Restrictive Doppler filling patterns, atrial enlargement, and pulmonary hypertension were observed among family members regardless of cardiomyopathy subtype. Mutation of a sarcomeric protein gene can cause RCM, HCM, and DCM within the same family, underscoring the necessity of comprehensive morphological and physiological cardiac assessment in familial cardiomyopathy screening.

Introduction Atrial fibrillation (AF) is a heritable disorder with male predilection, suggesting a sex chromosome defect in certain patients. Loss-of-function truncation mutations in EMD, encoding the nuclear membrane protein emerin, cause X-linked Emery-Dreifuss muscular dystrophy (EDMD) characterized by localized contractures and skeletal myopathy in adolescence, sinus node dysfunction (SND) in early adulthood, and atrial fibrillation as a variably associated trait. This study sought to identify the genetic basis for male-restricted, nonsyndromic sinus node dysfunction and AF in a multigenerational family. Methods and results Genealogical and medical records, and DNA samples, were obtained. Progressive SND and AF occurred in four males related through maternal lineages, consistent with X-linked inheritance. Skeletal myopathy was absent, even at advanced ages. Targeted X chromosome genotyping mapped the disease locus to Xq28, implicating EMD as a positional candidate gene. DNA sequencing revealed hemizygosity for an in-frame 3-bp deletion in EMD (Lys37del) in affected males, disrupting a residue within the LEM binding domain critical for nuclear assembly but leaving the remainder of the protein intact. Buccal epithelial cell staining with emerin antibody demonstrated near-total functional loss of emerin. Female relatives underwent prospective electrocardiographic and genetic testing. Those heterozygous for Lys37del had approximately 50-70% emerin-positive nuclei and variable degrees of paroxysmal supraventricular arrhythmia. Conclusions Mutation of EMD can underlie X-linked familial AF. Lys37del is associated with epithelial cell emerin deficiency, as in EDMD, yet it causes electrical atriomyopathy in the absence of skeletal muscle disease. Targeted genetic testing of EMD should be considered in patients with SND-associated AF and/or family history suggesting X-linked inheritance.

Background Induced pluripotent stem cells (iPSCs) derived from dilated cardiomyopathy (DCM) patients offer an unprecedented platform for in vitro disease modeling[1]. Time course transcriptome analysis on the differentiation process from iPSCs to beating cardiomyocytes will reveal the holistic dynamic gene expression landscapes and pinpoint molecular deficiencies in cardiogenesis for DCM patients.

To test the hypothesis that actin dysfunction leads to heart failure, patients with hereditary idiopathic dilated cardiomyopathy (IDC) were examined for mutations in the cardiac actin gene ( ACTC ). Missense mutations in ACTC that cosegregate with IDC were identified in two unrelated families. Both mutations affect universally conserved amino acids in domains of actin that attach to Z bands and intercalated discs. Coupled with previous data showing that dystrophin mutations also cause dilated cardiomyopathy, these results raise the possibility that defective transmission of force in cardiac myocytes is a mechanism underlying heart failure.

A third of inherited diseases result from premature termination codon mutations. Aminoglycosides have emerged as vanguard pharmacogenetic agents in treating human genetic disorders due to their unique ability to suppress gene translation termination induced by nonsense mutations. In preclinical and pilot clinical studies, this therapeutic approach shows promise in phenotype correction by promoting otherwise defective protein synthesis. The challenge ahead is to maximize efficacy while preventing interaction with normal protein production and function.

Dilated cardiomyopathy (DCM) is an idiopathic, genetically heterogeneous disorder characterized by heart failure and arrhythmia. Over the past decade, the molecular basis for DCM has been partially uncovered by discovery of mutation in genes encoding cystoskeletal, sarcomeric, nuclear membrane, and sarcoplasmic reticulum proteins. These findings have implicated pathogenic mechanisms whereby structural integrity, contractile force dynamics, and calcium regulation within the cardiac myocyte are perturbed. Recognition of dilated and hypertrophic cardiomyopathies as allelic disorders has provided the opportunity to identify genotype-phenotype relationships and to gain new insight into pathways leading to cardiac failure and hypertrophy. Conclusion: Collectively, family-based studies of DCM provide the rationale for clinical screening in first-degree relatives, regardless of family history or age of the index case. Discovery of novel genes for dilated cardiomyopathy is ongoing and will continue to advance our understanding of the pathobiology of heart failure.

ContextDilated cardiomyopathy (DCM), a genetically heterogeneous disorder, causes heart failure and rhythm disturbances. The majority of identified DCM genes encode structural proteins of the contractile apparatus and cytoskeleton. Recently, genetic defects in calcium and potassium regulation have been discovered in patients with DCM, implicating an alternative disease mechanism. The full spectrum of genetic defects in DCM, however, has not been established.ObjectivesTo identify a novel gene for DCM at a previously mapped locus, define the spectrum of mutations in this gene within a DCM cohort, and determine the frequency of DCM among relatives inheriting a mutation in this gene.Design, Setting, and ParticipantsRefined mapping of a DCM locus on chromosome 3p in a multigenerational family and mutation scanning in 156 unrelated probands with DCM, prospectively identified at the Mayo Clinic between 1987 and 2004. Relatives underwent screening echocardiography and electrocardiography and DNA sample procurement.Main Outcome MeasureCorrelation of identified mutations with cardiac phenotype.ResultsRefined locus mapping revealed SCN5A, encoding the cardiac sodium channel, as a candidate gene. Mutation scans identified a missense mutation (D1275N) that cosegregated with an age-dependent, variably expressed phenotype of DCM, atrial fibrillation, impaired automaticity, and conduction delay. In the DCM cohort, additional missense (T220I, R814W, D1595H) and truncation (2550-2551insTG) SCN5A mutations, segregating with cardiac disease or arising de novo, were discovered in unrelated probands. Among individuals with an SCN5A mutation 27% had early features of DCM (mean age at diagnosis, 20.3 years), 38% had DCM (mean age at diagnosis, 47.9 years), and 43% had atrial fibrillation (mean age at diagnosis, 27.8 years).ConclusionsHeritable SCN5A defects are associated with susceptibility to early-onset DCM and atrial fibrillation. Similar or even identical mutations may lead to heart failure, arrhythmia, or both.

Stress tolerance of the heart requires high-fidelity metabolic sensing by ATP-sensitive potassium (K(ATP)) channels that adjust membrane potential-dependent functions to match cellular energetic demand. Scanning of genomic DNA from individuals with heart failure and rhythm disturbances due to idiopathic dilated cardiomyopathy identified two mutations in ABCC9, which encodes the regulatory SUR2A subunit of the cardiac K(ATP) channel. These missense and frameshift mutations mapped to evolutionarily conserved domains adjacent to the catalytic ATPase pocket within SUR2A. Mutant SUR2A proteins showed aberrant redistribution of conformations in the intrinsic ATP hydrolytic cycle, translating into abnormal K(ATP) channel phenotypes with compromised metabolic signal decoding. Defective catalysis-mediated pore regulation is thus a mechanism for channel dysfunction and susceptibility to dilated cardiomyopathy.

Background: It is unknown whether progression of familial idiopathic dilated cardiomyopathy differs from progression in the non-familial form. It has been suggested that familial disease indicates a worse prognosis, and that this should be considered when planning the timing of heart transplantation. Objective: To compare five year survival or time to heart transplantation in an unselected series of patients with dilated cardiomyopathy who had been evaluated for familial v non-familial disease through the echocardiographic investigation of first degree relatives. Design: Medical records were reviewed and questionnaires were mailed to all patients who had previously participated in a family based study of dilated cardiomyopathy. Information was gathered about survival, heart transplantation, and left ventricular ejection fraction (LVEF) measurements. Survival data were censored at the time of cardiac transplantation. Results: Follow up data were obtained for 99 of 101 patients (69 with non-familial and 30 with familial disease). Five year survival was 55% for non-familial and 51% for familial patients (NS). The main predictor of mortality was an LVEF of < 30%. Familial status did not predict mortality. There was no significant difference in follow up LVEF values between the groups. Conclusions: Five year survival is not significantly different in the familial and non-familial forms of dilated cardiomyopathy.

Background — Vinculin and its isoform metavinculin are protein components of intercalated discs, structures that anchor thin filaments and transmit contractile force between cardiac myocytes. We tested the hypothesis that heritable dysfunction of metavinculin may contribute to the pathogenesis of dilated cardiomyopathy (DCM). Methods and Results — We performed mutational analyses of the metavinculin-specific exon of vinculin in 350 unrelated patients with DCM. One missense mutation (Arg975Trp) and one 3-bp deletion (Leu954del) were identified. These mutations involved conserved amino acids, were absent in 500 control individuals, and significantly altered metavinculin-mediated cross-linking of actin filaments in an in vitro assay. Ultrastructural examination was performed in one patient (Arg975Trp), revealing grossly abnormal intercalated discs. A potential risk-conferring polymorphism (Ala934Val), identified in one DCM patient and one control individual, had a less pronounced effect on actin filament cross-linking. Conclusions — These data provide genetic and functional evidence for vinculin as a DCM gene and suggest that metavinculin plays a critical role in cardiac structure and function. Disruption of force transmission at the thin filament-intercalated disc interface is the likely mechanism by which mutations in metavinculin may lead to DCM.

Background Hypoplastic left heart syndrome (HLHS) is a congenital heart defect in which the left ventricle of the heart is severely underdeveloped. Applying patient-specific induced pluripotent stem cells (iPSC) with highthroughput sequencing technology in RNA-seq and whole genome sequencing (WGS) provides an unprecedented opportunity to investigate the disease-specific transcription profiles linked to potential genetic causes in HLHS. Bioengineered HLHS patient-specific iPSCs and differentiated cardiac tissues offer a platform to recapitulate the individual developmental process to study the molecular causes of the disease.

Nitric oxide (NO) is a vasodilator that also possesses lipogenic properties. In rats, lipid accumulation and lipogenic enzymes are induced by NO and insulin-stimulated glucose uptake is dependent on intact NO synthesis in white adipose tissue. Mice in which the gene encoding inducible NO synthase was disrupted are protected from high-fat induced insulin resistance and NO inhibition in rodents on a high fat diet reduces hepatic lipid accumulation. These biological actions of NO are mediated by soluble guanylate cyclase (sGC) and importantly human adipocytes express the genes GUCY1A2, GUCY1A3, GUCY1B3 encoding for the alpha and beta subunits of sGC. The single nucleotide polymorphism rs13139571 is located within an intron of GUCY1A3 and its minor allele is associated with higher blood pressure and odds of hypertension in a recent genome wide association study. For the first time, we investigated the metabolic phenotype associated with rs13139571 in a random sample (n1⁄4 2007) of the general population from Olmsted County, MN. Frequencies of rs13139571 genotypes were CC: 59%, AC: 36%, AA: 5%. In age and gender adjusted analysis, carriers of the A minor allele had significantly higher plasma values of total cholesterol (CC: 202 36, AC: 204 36, AA: 208 34 mg/dl, p value1⁄4 0.04) and triglycerides (CC: 145 85, AC: 150 86, CC: 169 101 mg/dl, p value1⁄4 0.01). Metabolic syndrome trended toward increased prevalence in carriers of the minor allele (CC: 21%, AC: 23%, AA: 28%, p value1⁄4 0.06). Genotypes did not differ in terms of systolic blood pressure (CC: 132 22, AC: 134 21, CC: 132 21 mmHg, p value1⁄4 0.45), diastolic blood pressure (CC: 74 10, AC: 74 10, CC: 73 12 mmHg, p value1⁄4 0.77), BMI (CC: 28 5, 29 5, 28 5 Kg/m, p value1⁄4 0.43) and percentage of subjects on antilipemic therapy (CC: 17%, AC: 19%, AA: 18%, p value1⁄4 0.56). These studies suggest that the minor allele of rs13139571 may be associated with increased NO activity and influence lipid metabolism by favoring lipid accumulation and insulin resistance. Alternatively, rs13139571 may be in linkage disequilibrium with another genetic locus that affects cardiometabolic phenotype. Additional studies are warranted to confirm our findings and further investigate the metabolic phenotype associated with this genetic variant.

Proteins in cardiac myocytes assemble into contractile units known as sarcomeres. Contractile force is generated by interaction between sarcomeric thick and thin filaments. Thin filaments also transmit force within and between myocytes. Mutations in genes encoding the thin filament proteins actin and tropomyosin cause hypertrophic cardiomyopathy. Mutations affecting functionally distinct domains of actin also cause dilated cardiomyopathy (DCM). We used a non-positional candidate gene approach to test further the hypothesis that dysfunction of sarcomeric thin filaments, due to different mutations in the same gene, can lead to either hypertrophic or dilated cardiomyopathy. Mutational analyses of alpha-tropomyosin 1 were performed in patients with idiopathic DCM. We identified two mutations that alter highly conserved residues and that, unlike hypertrophic cardiomyopathy-associated mutations, cause localized charge reversal on the surface of tropomyosin. Therefore, substitution of different amino acid residues in the same thin filament proteins is associated with the distinct phenotypes of cardiac hypertrophy or congestive heart failure.

T. M. Olson, T. P. Doan, N. Y. Kishimoto, F. G. Whitby, M. J. Ackerman and L. Fananapazir. Inherited andde novo Mutations in the Cardiac Actin Gene Cause Hypertrophic Cardiomyopathy. Journal of Molecular and Cellular Cardiology (2000) 32, 1687–1694. Mutations in genes encoding sarcomeric proteins cause hypertrophic cardiomyopathy (HCM). The sarcomeric protein actin plays a central, dual role in cardiac myocytes, generating contractile force by interacting with myosin and also transmitting force within and between cells. Two missense mutations in the cardiac actin gene (ACTC), postulated to impair force transmission, have been associated with familial dilated cardiomyopathy (DCM). Recently, a missense mutation in ACTC was found to cosegregate with familial HCM. To further test the hypothesis that mutations within functionally distinct domains of ACTC cause either DCM or HCM, we performed mutational analyses in 368 unrelated patients with familial or sporadic HCM. Single strand conformation polymorphism and sequence analyses of genomic DNA were performed. De novo mutations in ACTC were identified in two patients with sporadic HCM who presented with syncope in early childhood. Patients were heterozygous for missense mutations resulting in Pro164Ala and Ala331Pro amino acid substitutions, adjacent to regions of actin-actin and actin-myosin interaction, respectively. A mutation that cosegregated with familial HCM was also found, causing a Glu99Lys substitution in a weak actomyosin binding domain. The cardiac phenotype in many affected patients was characterized by an apical form of HCM. These findings support the hypothesis that a single amino acid substitution in actin causes either congestive heart failure or maladaptive cardiac hypertrophy, depending on its effect on actin structure and function.

Can antiheart autoantibodies predict disease risk in asymptomatic relatives of patients with dilated cardiomyopathy?

It has been more than 2 decades since the seminal report by DeBold demonstrating the existence of atrial natriuretic peptide (ANP) as a cardiac hormone that links the heart and kidney in cardiorenal homeostasis.1 Since that discovery, a family of structurally similar but genetically distinct peptides have been reported that function via well-characterized particulate guanylyl cyclase receptors linked to cGMP. These include ANP and B-type naturetic peptide (BNP), which are ligands for the naturetic peptide receptor A, and C-type naturetic peptide, which binds to the naturetic peptide receptor B.2 In the current issue, Rame et al3 focus attention on the processing of the cardiac peptide prohormones to mature biologically active peptides by the protease corin. This study was predicated by the work by Yan et al,4 which established corin as the natriuretic peptide-converting enzyme for ANP and presumably BNP (Figure). This cleavage of the prohormone to the mature peptide is essential for biological activity exemplified by a novel murine model of corin deletion in which the phenotype is hypertension and cardiac hypertrophy.5 Processing of pro-ANP and pro-BNP. This figure illustrates the processing of these 2 procardiac natriuretic peptides by corin to biologically active mature cardiac natriuretic peptides ANP and BNP. These peptides mediate their …

We have isolated genomic DNA containing the human tissue inhibitor of metalloproteinases-4 gene (TIMP4) and determined the structure of the exons comprising the gene. Like other members of the TIMP family, the TIMP-4 protein is encoded by five exons. These span 6 kb of genomic DNA, so that TIMP4 is similar in size to Timp1 but considerably smaller than TIMP2 and TIMP3. The exon-intron boundaries of TIMP4 are at locations very similar to those of the other TIMP genes, demonstrating the high degree of conservation of gene structure in this family. The human and mouse TIMP-4 genes map to comparable locations in the respective genomes, localizing to human chromosome 3p25 and mouse chromosome 6.

Dilated cardiomyopathy (DCM) is a common disorder characterized by cardiac dilation and reduced systolic function. To identify a cardiomyopathy gene, we studied a family with DCM associated with sinus node dysfunction, supraventricular tachyarrhythmias, conduction delay, and stroke. A general linkage approach was used to localize the disease gene in this family. Linkage to D3S2303 was identified with a two-point lod score of 6.09 at a recombination fraction of 0.00. Haplotype analyses mapped this locus to a 30 cM region of chromosome 3p22-p25, excluding candidate genes encoding a G-protein (GNAI2), calcium channel (CACNL1A2), sodium channel (SCN5A), and inositol triphosphate receptor (ITPR1). These data indicate that a gene causing DCM associated with rhythm and conduction abnormalities is located on chromosome 3p, and represent the first step toward disease gene identification.

Case control studies have reported associations between specific HLA class II antigens and idiopathic dilated cardiomyopathy (DCM), suggesting that genetically regulated immune response factors may be involved in the pathogenesis of this disease. In this study, families with DCM were used to test the hypothesis that a heritable gene defect in the HLA region is the primary genetic determinant for a subset of cases. Twelve families with DCM were identified. By formal segregation analysis, the inheritance of the disease was most consistent with an autosomal dominant gene defect with incomplete penetrance. Genotyping was performed with five highly polymorphic linked dinucleotide repeat markers that span the HLA locus. Linkage analysis was used to determine whether or not these genetic markers cosegregated with the disease phenotype. Genetic linkage between the disease phenotype and a 21 cM region spanning the HLA was excluded (lod score < or = -2) in at least 60% of our families. These results indicate that a gene defect in the HLA locus region is not the primary genetic determinant of DCM in a series of familial cases. However, our data do not exclude the possibility that HLA regulated immune response factors may have a modifying effect on disease penetrance and expression.

Address: 1Cardiorenal Research Laboratory and Division of Cardiovascular Diseases, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA, 2Division of Cardiovascular Diseases, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA, 3Division of Epidemiology, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA, 4Division of Biostatistics, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA and 5Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Objectives We sought to identify a novel gene for dilated cardiomyopathy (DCM). Background DCM is a heritable, genetically heterogeneous disorder that remains idiopathic in the majority of patients. Familial cases provide an opportunity to discover unsuspected molecular bases of DCM, enabling pre-clinical risk detection. Methods Two large families with autosomal-dominant DCM were studied. Genome-wide linkage analysis was used to identify a disease locus, followed by fine mapping and positional candidate gene sequencing. Mutation scanning was then performed in 278 unrelated subjects with idiopathic DCM, prospectively identified at the Mayo Clinic. Results Overlapping loci for DCM were independently mapped to chromosome 10q25-q26. Deoxyribonucleic acid sequencing of affected individuals in each family revealed distinct heterozygous missense mutations in exon 9 of RBM20, encoding ribonucleic acid (RNA) binding motif protein 20. Comprehensive coding sequence analyses identified missense mutations clustered within this same exon in 6 additional DCM families. Mutations segregated with DCM (peak composite logarithm of the odds score >11.49), were absent in 480 control samples, and altered residues within a highly conserved arginine/serine (RS)-rich region. Expression of RBM20 messenger RNA was confirmed in human heart tissue. Conclusions Our findings establish RBM20as a DCM gene and reveal a mutation hotspot in the RS domain. RBM20is preferentially expressed in the heart and encodes motifs prototypical of spliceosome proteins that regulate alternative pre-messenger RNA splicing, thus implicating a functionally distinct gene in human cardiomyopathy. RBM20mutations are associated with young age at diagnosis, end-stage heart failure, and high mortality.

We clarify the structure of the four-dimensional low-energy effective action that encodes the conformal and $U(1)$ R-symmetry anomalies in an $\mathcal{N}=1$ supersymmetric field theory. The action depends on the dilaton, $\tau$, associated with broken conformal symmetry, and the Goldstone mode, $\beta$, of the broken $U(1)$ R-symmetry. We present the action for general curved spacetime and background gauge field up to and including all possible four-derivative terms. The result, constructed from basic principles, extends and clarifies the structure found by Schwimmer and Theisen in arXiv:1011.0696 using superfield methods. We show that the Goldstone mode $\beta$ does not interfere with the proof of the four-dimensional $a$-theorem based on $2 \to 2$ dilaton scattering. In fact, supersymmetry Ward identities ensure that a proof of the $a$-theorem can also be based on $2 \to 2$ Goldstone mode scattering when the low-energy theory preserves $\mathcal{N}=1$ supersymmetry. We find that even without supersymmetry, a Goldstone mode for any broken global $U(1)$ symmetry cannot interfere with the proof of the four-dimensional $a$-theorem., Comment: 18 pages

We construct the five-dimensional supergravity dual of the $\mathcal{N}=1^*$ mass deformation of the $\mathcal{N} =4$ supersymmetric Yang-Mills theory on $S^4$ and use it to calculate the universal contribution to the corresponding $S^4$ free energy at large 't Hooft coupling in the planar limit. The holographic RG flow solutions are smooth and preserve four supercharges. As a novel feature compared to the holographic duals of $\mathcal{N} = 1^*$ on $\mathbb{R}^4$, in our backgrounds the five-dimensional dilaton has a non-trivial profile, and the gaugino condensate is fixed in terms of the mass-deformation parameters. Important aspects of the analysis involve characterizing the ambiguities in the partition function of non-conformal $\mathcal{N}=1$ supersymmetric theories on $S^4$ as well as the action of S-duality on the $\mathcal{N}=1^*$ theory., Comment: 40 pages + appendices, 4 figures

Next-generation sequencing technology platforms are driving the development of a variety of approaches to study genomic variation associated with disease. One of these approaches, exome sequencing, specifically targets the coding regions of the genome, which are captured and sequenced. Compared with whole genome sequencing, exome sequencing offers the advantages of being cost- and time-effective while providing deeper coverage of coding variants, which are more likely to affect function. However, the protocol is known to be only partially reliable and might miss some of the coding regions. To assess how much coding region could be missed or of target, we compared whole genome and exome sequencing data derived from one sample that was processed by the Illumina GA-IIx platform. Our in-house-developed workflow named TREAT (Targeted RE-sequencing and Annotation Tool) was used to align and annotate the data. We provide a summary of the comparison between the two datasets, including the total number of reads produced, the time needed for sequencing and analysis, the coverage of coding regions and the agreement between called variants.

Address: 1Cardiorenal Research Laboratory and Division of Cardiovascular Diseases, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA, 2Division of Cardiovascular Diseases, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA, 3Division of Epidemiology, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA, 4Division of Biostatistics, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA and 5Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, Minnesota, USA

Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic cause of acute coronary syndrome with a predilection for young women. Genetic risk factors for SCAD are not well characterized. We performed a retrospective single-center descriptive analysis of consecutive patients with SCAD (n