New HTAD WG Consensus Statement on screening and management of patients with ACTA2-related vasculopathy published!

We are happy to announce that the position statement by the Heritable Thoracic Aortic Diseases (HTAD) Working Group entitled European reference network for rare vascular diseases (VASCERN) consensus statement for the screening and management of patients with pathogenic ACTA2 variants has just been published in the Orphanet Journal of Rare Diseases.

This consensus statement focuses on the diagnosis, pregnancy management, genetic counselling, monitoring and treatment of patients with an ACTA2-related vasculopathy, a rare autosomal dominant condition characterised by a main vascular phenotype of aortic aneurysm and risk of dissection, and occasional extravascular traits such as skin (i.e. livedo reticularis) and ocular abnormalities (i.e. iris flocculi).

The group started with an extensive literature review in order to formulate an inventory of questions that were then discussed at length (during two plenary sessions and one video conference call) before reaching a consensus on the recommendations for patients with pathogenic variants in the ACTA2 gene.

Read the abstract here:

The ACTA2 gene encodes for smooth muscle specific α-actin, a critical component of the contractile apparatus of the vascular smooth muscle cell. Pathogenic variants in the ACTA2 gene are the most frequently encountered genetic cause of non-syndromic hereditary thoracic aortic disease (HTAD). Although thoracic aortic aneurysm and/or dissection is the main clinical manifestation, a variety of occlusive vascular disease and extravascular manifestations occur in ACTA2-related vasculopathy. Current data suggest possible mutation-specific manifestations of vascular and extra-aortic traits.

Despite its relatively high prevalence, comprehensive recommendations on the care of patients and families with pathogenic variants in ACTA2 have not yet been established. We aimed to develop a consensus document to provide medical guidance for health care professionals involved in the diagnosis and treatment of patients and relatives with pathogenic variants in ACTA2.

The HTAD Working Group of the European Reference Network for Rare Vascular Diseases (VASCERN) convened to review current literature and discuss expert opinions on clinical management of ACTA2 related vasculopathy. This consensus statement summarizes our recommendations on diagnosis, monitoring, treatment, pregnancy, genetic counselling and testing in patients with ACTA2-related vasculopathy. However, there is a clear need for additional prospective multicenter studies to further define proper guidelines.”

We congratulate the members of the HTAD WG for this valuable clinical decision making tool.

Read the full article here


European reference network for rare vascular diseases (VASCERN) consensus statement for the screening and management of patients with pathogenic ACTA2 variants. van de Laar IMBH, Arbustini E, Loeys B, Björck E, Murphy L, Groenink M, Kempers M, Timmermans J, Roos-Hesselink J, Benke K, Pepe G, Mulder B, Szabolcs Z, Teixidó-Turà G, Robert L, Emmanuel Y, Evangelista A, Pini A, von Kodolitsch Y, Jondeau G, De Backer J. Orphanet J Rare Dis. 2019 Nov 21;14(1):264. doi: 10.1186/s13023-019-1186-2. PMID: 31752940 

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