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J Am Coll Cardiol, 2006; 48:1610-1617, doi:10.1016/j.jacc.2006.07.026 (Published online 26 September 2006).
© 2006 by the American College of Cardiology Foundation
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CLINICAL RESEARCH: HEART FAILURE

Identification of a Common Gene Expression Signature in Dilated Cardiomyopathy Across Independent Microarray Studies

Andreas S. Barth, MD*,*, Ruprecht Kuner, PhD§, Andreas Buness, MSc§, Markus Ruschhaupt, MSc{ddagger},§, Sylvia Merk, DVM{ddagger},||, Ludwig Zwermann, MD*, Stefan Kääb, MD*, Eckart Kreuzer, MD{dagger}, Gerhard Steinbeck, MD*, Ulrich Mansmann, PhD{ddagger}, Annemarie Poustka, PhD§, Michael Nabauer, MD* and Holger Sültmann, PhD§

* Department of Medicine I, University Hospital Grosshadern, Munich, Germany
{dagger} Department of Cardiac Surgery, University Hospital Grosshadern, Munich, Germany
{ddagger} Department of Medical Informatics, Biometrics and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
§ Division of Molecular Genome Analysis, German Cancer Research Center, Heidelberg, Germany
|| Department of Medical Informatics and Biomathematics, University of Münster, Münster, Germany

Manuscript received December 18, 2005; revised manuscript received April 14, 2006, accepted June 6, 2006.

* Reprint requests and correspondence: Dr. Andreas S. Barth, Department of Medicine I, University Hospital Grosshadern, Munich, Marchioninistrasse 15, 81377 Munich, Germany (Email: andreas.barth{at}med.uni-muenchen.de).

OBJECTIVES: This study was designed to identify a common gene expression signature in dilated cardiomyopathy (DCM) across different microarray studies.

BACKGROUND: Dilated cardiomyopathy is a common cause of heart failure in Western countries. Although gene expression arrays have emerged as a powerful tool for delineating complex disease patterns, differences in platform technology, tissue heterogeneity, and small sample sizes obscure the underlying pathophysiologic events and hamper a comprehensive interpretation of different microarray studies in heart failure.

METHODS: We accounted for tissue heterogeneity and technical aspects by performing 2 genome-wide expression studies based on cDNA and short-oligonucleotide microarray platforms which comprised independent septal and left ventricular tissue samples from nonfailing (NF) (n = 20) and DCM (n = 20) hearts.

RESULTS: Concordant results emerged for major gene ontology classes between cDNA and oligonucleotide microarrays. Notably, immune response processes displayed the most pronounced down-regulation on both microarray types, linking this functional gene class to the pathogenesis of end-stage DCM. Furthermore, a robust set of 27 genes was identified that classified DCM and NF samples with >90% accuracy in a total of 108 myocardial samples from our cDNA and oligonucleotide microarray studies as well as 2 publicly available datasets.

CONCLUSIONS: For the first time, independent microarray datasets pointed to significant involvement of immune response processes in end-stage DCM. Moreover, based on 4 independent microarray datasets, we present a robust gene expression signature of DCM, encouraging future prospective studies for the implementation of disease biomarkers in the management of patients with heart failure.

Abbreviations and Acronyms
  DCM = dilated cardiomyopathy
  GO = Gene Ontology
  ICM = ischemic cardiomyopathy
  NF = nonfailing


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