CARDIOGENOMICS • PRECISION REFERRAL SUPPORT

Cardiac Genomics

Genomic and pharmacogenomic testing to clarify inherited cardiovascular disease, identify at-risk relatives and support selected treatment decisions.

Clinician-focused service: phenotype-led test selection, specimen coordination and family-testing guidance.

Cardiac genomics illustration showing a human heart, DNA double helix and ECG trace

Inherited disease

Panels for cardiomyopathy, channelopathy, aortopathy, familial hypercholesterolaemia and pulmonary arterial hypertension.

Family risk

Support cascade testing and focused surveillance when a clinically relevant familial variant is identified.

Therapy insight

Selected CYP2C19 and warfarin-response testing can complement clinical prescribing decisions.

HIGHEST CLINICAL UTILITY FOR ADULT CARDIOLOGISTS

Phenotype-led pathways with actionable family implications

Genetic testing is most informative when the phenotype, pedigree and clinical question are clearly defined. The panels below represent practical high-yield referral pathways.

Cardiomyopathy & inherited arrhythmia

Cardiomyopathy gene panel — unexplained HCM, DCM, ARVC, LV non-compaction or restrictive cardiomyopathy; early-onset heart failure; family history or sudden cardiac death.

Cardiomyopathy panel—expedited — the same indications when a faster result is clinically important.

Cardiac channelopathy gene panel — long-QT, Brugada, CPVT, short-QT, unexplained ventricular arrhythmia, cardiac arrest or sudden death.

Channelopathy panel—expedited — urgent inherited-arrhythmia evaluation.

Lipid & pulmonary vascular genetics

Hypercholesterolaemia gene panel — severe LDL elevation, suspected familial hypercholesterolaemia, premature CAD or cascade screening.

Pulmonary arterial hypertension genetic test — idiopathic or heritable PAH, young-onset disease, family history or suspected PVOD/PCH.

Aortopathy & connective-tissue disorders

Connective-tissue disorder / aortopathy panel — familial thoracic aortic aneurysm or dissection, syndromic aortopathy, or an overlapping Marfan–Loeys–Dietz–EDS phenotype.

Marfan syndrome—FBN1 analysis — aortic-root dilatation with Marfanoid features or family history.

Ehlers–Danlos syndrome gene panel — arterial fragility, aneurysm/dissection or syndromic connective-tissue findings.

Amyloidosis, Fabry & iron overload

Transthyretin—TTR sequencing — after ATTR cardiac amyloidosis is demonstrated, to distinguish hereditary ATTR from wild-type disease and guide family testing.

Fabry disease—GLA analysis — unexplained LV hypertrophy/HCM phenotype, especially with renal, neurological, dermatological or family findings. Consider GLA deletion/duplication analysis if sequencing is negative and suspicion remains.

Haemochromatosis gene panel — cardiomyopathy or arrhythmia accompanied by biochemical or radiological evidence of iron overload.

Cardiovascular pharmacogenomics illustration showing DNA, antiplatelet response and coagulation pathways
CARDIOVASCULAR PHARMACOGENOMICS

Selected tests that can inform prescribing

Use results alongside indication, comorbidity, concomitant treatment and current guideline recommendations.

CYP2C19 clopidogrel resistance—all CPIC alleles
Identifies loss-of-function and increased-function metaboliser phenotypes relevant to clopidogrel selection after PCI or ACS.

CYP2C19 *2 and *3 only
A faster, limited assay for the two major loss-of-function alleles; the broader all-CPIC assay is preferable when feasible.

Warfarin-response genotyping—VKORC1, CYP2C9 and CYP4F2
May support genotype-assisted initial dosing in selected patients; it does not replace INR monitoring.

Timing matters: Published turnaround is approximately 5–12 days for clopidogrel testing and approximately 12 days for warfarin genotyping. These tests are unlikely to guide an immediate emergency PCI decision unless performed prospectively.

CAD RISK SCREENING PRODUCTS

Add genomic risk information to conventional assessment

These products are intended for risk stratification—not diagnosis—and should be interpreted with lipids, blood pressure, diabetes status, smoking, family history and validated clinical risk scoring.

CAD Polygenic Risk Test

Estimates inherited polygenic susceptibility to coronary artery disease.

Kardiogen Plus

Integrated CAD risk score combining genomic risk with relevant clinical factors.

Kardiogen Plus—analysis only

Analysis-only pathway; contact the laboratory to confirm eligibility and required inputs.

Kardiogen + Curegen

CAD genetic-risk assessment together with a pharmacogenomic report.

Kardiogen + Curegen Advanced

Expanded combined genomic-risk and pharmacogenomic package.

Clinical note: These tests supplement—not replace—standard cardiovascular risk assessment. They are not diagnostic tests.

PAEDIATRIC & CONGENITAL CARDIOLOGY

Genetic investigations guided by the syndromic phenotype

Testing should be selected according to the cardiac lesion, extracardiac features, developmental findings and family history.

Syndromic congenital heart disease

Noonan syndrome gene panel — pulmonary stenosis, HCM or congenital heart disease with RASopathy features.

DiGeorge / 22q11.2 deletion–duplication by MLPA — conotruncal defects, interrupted aortic arch, hypocalcaemia or immunodeficiency.

FISH for DiGeorge/VCF syndrome — targeted 22q11.2 deletion testing.

FISH for Williams syndrome — supravalvular aortic stenosis with characteristic syndromic findings.

Additional congenital pathways

Alagille syndrome gene panel / JAG1 deletion–duplication — peripheral pulmonary stenosis with cholestasis or characteristic phenotype.

GDF1 and PKD1L1 sequencing (MGM1121) — selected heterotaxy/laterality-associated congenital heart defects.

Chromosomal microarray / KaryoTrack — multiple congenital anomalies, developmental delay or syndromic congenital heart disease.

All genomic tests are Out sourced to MedGenome Labs

A PRACTICAL JAGRUTHI REFERRAL MENU

Start with the tests most likely to change family counselling or clinical direction

Priority referral pathways: cardiomyopathy, channelopathy, familial hypercholesterolaemia, aortopathy/Marfan syndrome, pulmonary arterial hypertension, TTR amyloidosis, Fabry disease and CYP2C19 clopidogrel testing.

Specimen: Most assays accept peripheral blood in EDTA or direct DNA. Contact the laboratory before collection to confirm the current gene content, specimen requirement, price and turnaround time.