Current state of genetic testing for cardiac diseases in Croatia in comparison to ESC countries: an EHRA physician-based survey results

    Authors

    Keywords

    genetic testing, inherited disease, guidelines, clinical practice, adherence

    DOI

    https://doi.org/10.15836/ccar2024.531

    Full Text

    **Introduction:** Genetic testing in the cardiovascular field has advanced significantly in the past years, with expanding indications. (1, 2) The aim of this physician based European Heart Rhythm Association (EHRA) survey was to provide a snapshot on current clinical practice regarding the genetic testing for cardiac diseases across ESC countries. Croatia provided most responses, thus we compared Croatia to all other ESC countries included in the survey. **Methods:** An online 28-item questionnaire was promoted by the Scientific Initiative Committee of EHRA, the European Cardiac Arrhythmia Genetics Focus Group (ECGen) and the Young Electrophysiologists Committee and disseminated through EHRA Research Network and dedicated social media channels. **Results:** There were 357 respondents from 69 countries (48 ESC), out of which 60 from Croatia. The majority were cardiac electrophysiologists working in a University Hospitals. Most respondents, including in Croatia, indicated to have performed < 10 genetic tests in the last year. Half of the respondents sent their samples to the regional or national genetic laboratory; however, Croatia has no genetic laboratory in the country and all samples are sent to the laboratory abroad. The main reason for not providing genetic testing were no availability of the genetic lab/facility (35%) or reimbursement issues (25%), similar to Croatian responses. The most frequent indication for genetic testing was diagnostic purposes (55%). Clinical usage of genetic testing in the diagnostic, prognostic, and therapeutic assessment showed heterogeneity depending on the examined inherited disease, but high adherence to current guidelines. **Conclusion:** The survey highlights a significant heterogeneity of the of genetic testing clinical usage in Croatia compared to different ESC countries, mostly due to the differences in availability of genetic lab/facility and reimbursement issues but shows high adherence to current recommendations regarding the indications.

    Literature

    1. Specterman MJ, Behr ER. Cardiogenetics: the role of genetic testing for inherited arrhythmia syndromes and sudden death. Heart. 2023;109(6):434–41. https://doi.org/10.1136/heartjnl-2021-320015
    2. Conte G, Scherr D, Lenarczyk R, Gandjbachkh E, Boulé S, Spartalis MD, et al. Diagnosis, family screening, and treatment of inherited arrhythmogenic diseases in Europe: results of the European Heart Rhythm Association Survey. Europace. 2020;22(12):1904–10. https://doi.org/10.1093/europace/euaa223
    Cardiologia Croatica
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    Current state of genetic testing for cardiac diseases in Croatia in comparison to ESC countries: an EHRA physician-based survey results

    Extended Abstract
    Issue11-12
    Published
    Pages531
    PDF via DOIhttps://doi.org/10.15836/ccar2024.531
    genetic testing
    inherited disease
    guidelines
    clinical practice
    adherence

    Authors

    Ivan Zeljković*ORCIDDubrava University Hospital, Zagreb, Croatia
    Anais GautheyORCIDHeart Rhythm Management Center, Brussels, Belgium
    Martin ManningerORCIDDivision of Cardiology, Department of Internal Medicine, Graz, Austria
    Katarzyna Malaczynska-RajpoldORCIDCardiology Department, Royal Brompton Hospital, London, United Kingdom
    Federico MiglioreORCIDDepartment of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova, Italy
    Šime ManolaORCIDDubrava University Hospital, Zagreb, Croatia
    Nikola PavlovićORCIDDubrava University Hospital, Zagreb, Croatia
    Julian ChunORCIDCardioangiologisches Centrum Bethanien, Agaplesion Bethanien Krankenhaus, Frankfurt, Germany
    Giulio ConteORCIDDivision of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland

    *Correspondence email: ivanzeljkov@gmail.com

    Full Text

    Introduction: Genetic testing in the cardiovascular field has advanced significantly in the past years, with expanding indications. (1, 2) The aim of this physician based European Heart Rhythm Association (EHRA) survey was to provide a snapshot on current clinical practice regarding the genetic testing for cardiac diseases across ESC countries. Croatia provided most responses, thus we compared Croatia to all other ESC countries included in the survey.

    Methods: An online 28-item questionnaire was promoted by the Scientific Initiative Committee of EHRA, the European Cardiac Arrhythmia Genetics Focus Group (ECGen) and the Young Electrophysiologists Committee and disseminated through EHRA Research Network and dedicated social media channels.

    Results: There were 357 respondents from 69 countries (48 ESC), out of which 60 from Croatia. The majority were cardiac electrophysiologists working in a University Hospitals. Most respondents, including in Croatia, indicated to have performed < 10 genetic tests in the last year. Half of the respondents sent their samples to the regional or national genetic laboratory; however, Croatia has no genetic laboratory in the country and all samples are sent to the laboratory abroad. The main reason for not providing genetic testing were no availability of the genetic lab/facility (35%) or reimbursement issues (25%), similar to Croatian responses. The most frequent indication for genetic testing was diagnostic purposes (55%). Clinical usage of genetic testing in the diagnostic, prognostic, and therapeutic assessment showed heterogeneity depending on the examined inherited disease, but high adherence to current guidelines.

    Conclusion: The survey highlights a significant heterogeneity of the of genetic testing clinical usage in Croatia compared to different ESC countries, mostly due to the differences in availability of genetic lab/facility and reimbursement issues but shows high adherence to current recommendations regarding the indications.

    Literature

    1. 1.
      Specterman MJ, Behr ER. Cardiogenetics: the role of genetic testing for inherited arrhythmia syndromes and sudden death. Heart. 2023;109(6):434–41.DOI
    2. 2.
      Conte G, Scherr D, Lenarczyk R, Gandjbachkh E, Boulé S, Spartalis MD, et al. Diagnosis, family screening, and treatment of inherited arrhythmogenic diseases in Europe: results of the European Heart Rhythm Association Survey. Europace. 2020;22(12):1904–10.DOI