dilated cardiomyopathy 1G

disease
On this page

Also known as cardiomyopathy, dilated, 1Gcardiomyopathy, dilated, type 1GCMD1Gdilated cardiomyopathy type 1Gfamilial isolated dilated cardiomyopathy caused by mutation in TTNTTN familial isolated dilated cardiomyopathy

Summary

dilated cardiomyopathy 1G (MONDO:0011400) is a disease caused by TTN (GenCC Definitive), with 11 cohort genes.

At a glance

  • Causal gene: TTN (GenCC Definitive)
  • Cohort genes: 11
  • ClinVar variants: 26,884

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

FieldValue
Canonical namedilated cardiomyopathy 1G
Mondo IDMONDO:0011400
MeSHC565824
OMIM604145
DOIDDOID:0110430
UMLSC1858763
MedGen347714
GARD0015363
Is cancer (heuristic)no

Also known as: cardiomyopathy, dilated, 1G · cardiomyopathy, dilated, type 1G · CMD1G · dilated cardiomyopathy type 1G · familial isolated dilated cardiomyopathy caused by mutation in TTN · TTN familial isolated dilated cardiomyopathy

Data availability: 26,884 ClinVar variants · 3 GenCC gene-disease records · 12 cell lines.

Disease family

Classification path: disease › human disease › disease by etiologic mechanism › disease of genetic or genomic mechanism › hereditary disease › autosomal genetic disease › autosomal dominant disease › autosomal dominant titinopathy › dilated cardiomyopathy 1G

Related subtypes (4): tibial muscular dystrophy, myopathy, myofibrillar, 9, with early respiratory failure, hypertrophic cardiomyopathy 9, TTN-related myopathy, dominant-negative TTNsv

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

ClinVar germline variants

600 retrieved; paginated sample, class counts are floors:

238 likely pathogenic, 172 uncertain significance, 140 likely benign, 18 pathogenic, 18 conflicting classifications of pathogenicity, 13 pathogenic/likely pathogenic, 1 benign

ClinVarVariant (HGVS)GeneClassificationReview
1012352NM_001267550.2(TTN):c.68302A>T (p.Lys22768Ter)LOC126806423Pathogenicno assertion criteria provided
1011266NM_001267550.2(TTN):c.6825del (p.Asp2275fs)TTNPathogeniccriteria provided, single submitter
1012335NM_001267550.2(TTN):c.81274C>T (p.Gln27092Ter)TTNPathogenicno assertion criteria provided
1012351NM_001267550.2(TTN):c.49669A>T (p.Lys16557Ter)TTNPathogenicno assertion criteria provided
1012357NM_001267550.2(TTN):c.3073dup (p.Ser1025fs)TTNPathogenicno assertion criteria provided
1012358NM_001267550.2(TTN):c.58240_58244del (p.Pro19414fs)TTNPathogenicno assertion criteria provided
1015906NM_001267550.2(TTN):c.26287G>T (p.Glu8763Ter)TTNPathogeniccriteria provided, single submitter
1016464NM_001267550.2(TTN):c.32312-1G>CTTNPathogeniccriteria provided, single submitter
1030169NM_001267550.2(TTN):c.107224-1G>CTTNPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1035316NM_001267550.2(TTN):c.6570dup (p.Met2191fs)TTNPathogeniccriteria provided, single submitter
1057336NM_001267550.2(TTN):c.3344G>A (p.Trp1115Ter)TTNPathogeniccriteria provided, single submitter
1065903NM_001267550.2(TTN):c.47314C>T (p.Arg15772Ter)TTNPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1066283NM_001267550.2(TTN):c.93088del (p.Arg31030fs)TTNPathogeniccriteria provided, single submitter
1066477NM_001267550.2(TTN):c.101687C>A (p.Ser33896Ter)TTNPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1066644NM_001267550.2(TTN):c.96849del (p.Gly32284fs)TTNPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1066907NM_001267550.2(TTN):c.51667C>T (p.Arg17223Ter)TTNPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1067013NM_001267550.2(TTN):c.69421_69422insAAAAG (p.Gly23141fs)TTNPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1067751NM_001267550.2(TTN):c.66968del (p.Asn22323fs)TTNPathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1069899NM_001267550.2(TTN):c.77646del (p.Ile25883fs)TTNPathogeniccriteria provided, single submitter
1071779NM_001267550.2(TTN):c.88462dup (p.Cys29488fs)TTNPathogeniccriteria provided, single submitter
1074124NM_001267550.2(TTN):c.67348C>T (p.Gln22450Ter)TTNPathogeniccriteria provided, multiple submitters, no conflicts
1076903NM_001267550.2(TTN):c.85011_85014del (p.Glu28338fs)TTNPathogeniccriteria provided, single submitter
1012354NM_001267550.2(TTN):c.94754T>G (p.Leu31585Ter)TTN-AS1Pathogenicno assertion criteria provided
1012355NM_001267550.2(TTN):c.54809del (p.Ile18270fs)TTN-AS1Pathogenicno assertion criteria provided
1030165NM_001267550.2(TTN):c.91920G>A (p.Trp30640Ter)TTN-AS1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1061173NM_001267550.2(TTN):c.46603C>T (p.Arg15535Ter)TTN-AS1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1066067NM_001267550.2(TTN):c.53206C>T (p.Arg17736Ter)TTN-AS1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1067228NM_001267550.2(TTN):c.95872C>T (p.Arg31958Ter)TTN-AS1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts
1067472NM_001267550.2(TTN):c.83971C>T (p.Gln27991Ter)TTN-AS1Pathogeniccriteria provided, multiple submitters, no conflicts
1068107NM_001267550.2(TTN):c.47797A>T (p.Arg15933Ter)TTN-AS1Pathogenic/Likely pathogeniccriteria provided, multiple submitters, no conflicts

Genes & proteins

Mendelian disease overlap and somatic drivers

GenCC: 21 · Orphanet: 32 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0

GenCC gene–disease validity (cohort genes)

the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.

GeneClassificationInheritanceDiseaseRecords
TTNDefinitiveAutosomal dominantdilated cardiomyopathy 1G21

Orphanet rare-disease linkage (cohort genes)

GeneOrphanet IDRare disease
TTNOrphanet:140922Titin-related limb-girdle muscular dystrophy R10
TTNOrphanet:154Familial isolated dilated cardiomyopathy
TTNOrphanet:169186Autosomal recessive centronuclear myopathy
TTNOrphanet:178464Hereditary myopathy with early respiratory failure
TTNOrphanet:289377Early-onset myopathy with fatal cardiomyopathy
TTNOrphanet:293888Inherited isolated arrhythmogenic cardiomyopathy, dominant-left variant
TTNOrphanet:293899Inherited isolated arrhythmogenic ventricular dysplasia, biventricular variant
TTNOrphanet:293910Inherited isolated arrhythmogenic cardiomyopathy, dominant-right variant
TTNOrphanet:324604Classic multiminicore myopathy
TTNOrphanet:334Hereditary atrial fibrillation
TTNOrphanet:466921Childhood-onset progressive contractures-limb-girdle weakness-muscle dystrophy syndrome
TTNOrphanet:609Tibial muscular dystrophy
TTNOrphanet:707983Early-onset autosomal recessive TTN-related distal myopathy
CORINOrphanet:275555Preeclampsia
CCDC141Orphanet:478Kallmann syndrome
DSPOrphanet:154Familial isolated dilated cardiomyopathy
DSPOrphanet:158687Lethal acantholytic erosive disorder
DSPOrphanet:2032Idiopathic pulmonary fibrosis
DSPOrphanet:293165Skin fragility-woolly hair-palmoplantar keratoderma syndrome
DSPOrphanet:293888Inherited isolated arrhythmogenic cardiomyopathy, dominant-left variant
DSPOrphanet:293899Inherited isolated arrhythmogenic ventricular dysplasia, biventricular variant
DSPOrphanet:293910Inherited isolated arrhythmogenic cardiomyopathy, dominant-right variant
DSPOrphanet:369992Severe dermatitis-multiple allergies-metabolic wasting syndrome
DSPOrphanet:476096Erythrokeratodermia-cardiomyopathy syndrome
DSPOrphanet:50942Striate palmoplantar keratoderma
DSPOrphanet:65282Carvajal syndrome
LRP4Orphanet:3152Sclerosteosis
LRP4Orphanet:3258Cenani-Lenz syndrome
LRP4Orphanet:98913Postsynaptic congenital myasthenic syndrome
PMS2Orphanet:144Lynch syndrome
PMS2Orphanet:252202Constitutional mismatch repair deficiency syndrome
PRKRAOrphanet:210571Dystonia 16

Cohort genes → proteins

11 cohort genes, 9 distinct canonical proteins.

Evidence partition

SubsetGenes
multi_evidence11

Cohort genes (full)

SymbolHGNCEnsemblUniProtNameEvidence
TTNHGNC:12403ENSG00000155657Q8WZ42Titingencc,clinvar
PLEKHA3HGNC:14338ENSG00000116095Q9HB20Pleckstrin homology domain-containing family A member 3clinvar
CORINHGNC:19012ENSG00000145244Q9Y5Q5Atrial natriuretic peptide-converting enzymeclinvar
CCDC141HGNC:26821ENSG00000163492Q6ZP82Coiled-coil domain-containing protein 141clinvar
DSPHGNC:3052ENSG00000096696P15924Desmoplakinclinvar
FKBP7HGNC:3723ENSG00000079150Q9Y680Peptidyl-prolyl cis-trans isomerase FKBP7clinvar
TTN-AS1HGNC:44124ENSG00000237298TTN antisense RNA 1clinvar
CYLD-AS1HGNC:55352ENSG00000261644CYLD antisense RNA 1clinvar
LRP4HGNC:6696ENSG00000134569O75096Low-density lipoprotein receptor-related protein 4clinvar
PMS2HGNC:9122ENSG00000122512P54278Mismatch repair endonuclease PMS2clinvar
PRKRAHGNC:9438ENSG00000180228O75569Interferon-inducible double-stranded RNA-dependent protein kinase activator Aclinvar

Cohort function summary

Lead sentence per gene, UniProt-curated.

SymbolProtein nameFunction (lead sentence)
TTNTitinKey component in the assembly and functioning of vertebrate striated muscles.
PLEKHA3Pleckstrin homology domain-containing family A member 3Plays a role in regulation of vesicular cargo transport from the trans-Golgi network (TGN) to the plasma membrane.
CORINAtrial natriuretic peptide-converting enzymeSerine-type endopeptidase involved in atrial natriuretic peptide (NPPA) and brain natriuretic peptide (NPPB) processing.
CCDC141Coiled-coil domain-containing protein 141Plays a critical role in cortical radial and GnRH neurons migration during brain development.
DSPDesmoplakinA component of desmosome cell-cell junctions which are required for positive regulation of cellular adhesion.
FKBP7Peptidyl-prolyl cis-trans isomerase FKBP7PPIases accelerate the folding of proteins during protein synthesis.
LRP4Low-density lipoprotein receptor-related protein 4Mediates SOST-dependent inhibition of bone formation.
PMS2Mismatch repair endonuclease PMS2Component of the post-replicative DNA mismatch repair system (MMR).
PRKRAInterferon-inducible double-stranded RNA-dependent protein kinase activator AActivates EIF2AK2/PKR in the absence of double-stranded RNA (dsRNA), leading to phosphorylation of EIF2S1/EFI2-alpha and inhibition of translation and induction of apoptosis.

Protein-family classification

Druggable: 3 · Difficult: 2 · Unknown: 6 · Druggable fraction: 0.27

Family distribution

Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.

FamilyGenesFoldFDR
Protease13.3×0.416
Scaffold/PPI23.1×0.416
Antibody/Immunoglobulin12.6×0.416
Kinase12.5×0.416
Other/Unknown61.0×0.654

Per-gene assignment

SymbolFamilyDruggable?ECInterPro (top 3)
TTNKinaseyes2.7.11.1Prot_kinase_dom, Ig_sub2, Ig_sub
PLEKHA3Scaffold/PPInoPH_domain, PH-like_dom_sf, Boi1/Boi2-like
CORINProteaseyesSRCR, Trypsin_dom, LDrepeatLR_classA_rpt
CCDC141Antibody/ImmunoglobulinyesSpectrin_repeat, Ig_sub2, Ig_sub
DSPScaffold/PPInoPlectin_repeat, SH3_domain, Spectrin/alpha-actinin
FKBP7Other/UnknownnoPPIase_FKBP_dom, EF_hand_dom, EF-hand-dom_pair
TTN-AS1Other/Unknownno
CYLD-AS1Other/Unknownno
LRP4Other/UnknownnoLDLR_classB_rpt, EGF, EGF-like_Ca-bd_dom
PMS2Other/UnknownnoMutL/Mlh/PMS, DNA_mismatch_S5_2-like, Ribsml_uS5_D2-typ_fold_subgr
PRKRAOther/UnknownnodsRBD_dom, PRKRA_DSRM_1, PRKRA_DSRM_2

Expression context

Cohort genes with no expression data: 0.

10 cohort genes are a single-cell marker in ≥1 SCXA experiment.

Breadth distribution (Bgee present_calls)

BucketGenes
narrow (1-5 tissues)0
moderate (6-20)0
broad (>20)11
unknown0

Top tissues across cohort

TissueCohort genes
biceps brachii2
skeletal muscle tissue of biceps brachii2
right atrium auricular region2
gluteal muscle1
endothelial cell1
epithelial cell of pancreas1
oviduct epithelium1
cardiac muscle of right atrium1
heart right ventricle1
myocardium1
adrenal tissue1
heart left ventricle1
hair follicle1
skin of hip1
upper leg skin1
calcaneal tendon1
left ovary1
stromal cell of endometrium1
gastrocnemius1
hindlimb stylopod muscle1

Per-gene tissue summary (top 30)

SymbolBgee breadthFANTOM5 breadthSCXATop tissues
TTN223broadmarkerbiceps brachii, gluteal muscle, skeletal muscle tissue of biceps brachii
PLEKHA3259ubiquitousmarkerepithelial cell of pancreas, oviduct epithelium, endothelial cell
CORIN176tissue_specificmarkercardiac muscle of right atrium, heart right ventricle, myocardium
CCDC141149broadmarkerheart left ventricle, adrenal tissue, right atrium auricular region
DSP253ubiquitousmarkerskin of hip, upper leg skin, hair follicle
FKBP7230ubiquitousmarkerstromal cell of endometrium, calcaneal tendon, left ovary
TTN-AS1174ubiquitousmarkerhindlimb stylopod muscle, gastrocnemius, right atrium auricular region
CYLD-AS1126yesgranulocyte, monocyte, leukocyte
LRP4242ubiquitousmarkerventricular zone, dorsal motor nucleus of vagus nerve, medial globus pallidus
PMS2143ubiquitousmarkerthymus, prefrontal cortex, male germ line stem cell (sensu Vertebrata) in testis
PRKRA294ubiquitousmarkersperm, skeletal muscle tissue of biceps brachii, biceps brachii

Protein interactions among cohort

Intra-cohort edges: 1.

Hub genes (top 10 by interactor count)

SymbolInteractor count
TTN4,237
DSP2,897
PMS22,658
PRKRA2,410
FKBP72,058
CORIN1,291
CCDC1411,255
LRP41,250
PLEKHA3810
TTN-AS10

Intra-cohort edges

ABSources
FKBP7PLEKHA3string_interaction

Structural data

PDB: 6 · AlphaFold-only: 3 · No structure: 2

Cohort genes with PDB structures (top 30)

SymbolUniProtPDB entries
TTNQ8WZ4264
PMS2P542789
DSPP159244
PLEKHA3Q9HB203
PRKRAO755692
LRP4O750961

AlphaFold-only cohort genes (top 30 by pLDDT)

SymbolUniProtpLDDT
FKBP7Q9Y68086.12
CCDC141Q6ZP8272.36
CORINQ9Y5Q570.20

Function

Pathway analysis

Distinct Reactome pathways touched by cohort: 20. Enrichment computed across 11 evidence-associated genes (7 with Reactome annotation).

Pathways by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 7 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

PathwayCohort genesFoldFDRSample cohort genes
Defective Mismatch Repair Associated With MLH11815.7×0.012PMS2
Defective Mismatch Repair Associated With PMS21815.7×0.012PMS2
Small interfering RNA (siRNA) biogenesis1163.1×0.029PRKRA
Apoptotic cleavage of cell adhesion proteins1148.3×0.029DSP
Mismatch repair (MMR) directed by MSH2:MSH6 (MutSalpha)1116.5×0.029PMS2
Mismatch repair (MMR) directed by MSH2:MSH3 (MutSbeta)1116.5×0.029PMS2
Physiological factors196.0×0.030CORIN
MicroRNA (miRNA) biogenesis165.3×0.038PRKRA
Striated Muscle Contraction144.1×0.048TTN
RND1 GTPase cycle137.9×0.048DSP
RND3 GTPase cycle137.1×0.048DSP
Synthesis of PIPs at the plasma membrane130.2×0.054PLEKHA3
TP53 Regulates Transcription of DNA Repair Genes125.9×0.058PMS2
ECM proteoglycans121.5×0.065LRP4
PKR-mediated signaling120.1×0.065PRKRA
Platelet degranulation112.6×0.091TTN
Formation of the cornified envelope112.6×0.091DSP
Extracellular matrix organization19.0×0.118LRP4
Keratinization18.0×0.125DSP
Neutrophil degranulation13.3×0.267DSP

GO biological processes by enrichment

Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 8 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.

GO termCohort genesFoldFDRSample cohort genes
positive regulation of presynaptic membrane organization12106.5×0.016LRP4
regulation of systemic arterial blood pressure by atrial natriuretic peptide1702.2×0.016CORIN
skeletal muscle myosin thick filament assembly1702.2×0.016TTN
sarcomerogenesis1702.2×0.016TTN
synaptic assembly at neuromuscular junction1702.2×0.016LRP4
regulation of regulatory ncRNA processing1702.2×0.016PRKRA
somatic recombination of immunoglobulin gene segments1526.6×0.016PMS2
regulation of renal sodium excretion1526.6×0.016CORIN
skeletal muscle thin filament assembly1351.1×0.016TTN
positive regulation of isotype switching to IgA isotypes1351.1×0.016PMS2
ventricular compact myocardium morphogenesis1300.9×0.016DSP
detection of muscle stretch1300.9×0.016TTN
bundle of His cell-Purkinje myocyte adhesion involved in cell communication1300.9×0.016DSP
postsynaptic membrane assembly1300.9×0.016LRP4
desmosome organization1263.3×0.016DSP
amyloid-beta clearance by cellular catabolic process1263.3×0.016LRP4
siRNA processing1234.1×0.016PRKRA
skeletal muscle acetylcholine-gated channel clustering1234.1×0.016LRP4
protein localization to cell-cell junction1234.1×0.016DSP
positive regulation of skeletal muscle acetylcholine-gated channel clustering1234.1×0.016LRP4
cardiac muscle hypertrophy1210.7×0.016TTN
cerebral cortex radially oriented cell migration1210.7×0.016CCDC141
presynaptic membrane assembly1210.7×0.016LRP4
outer ear morphogenesis1191.5×0.016PRKRA
positive regulation of isotype switching to IgG isotypes1191.5×0.016PMS2
generation of neurons1191.5×0.016LRP4
RISC complex assembly1191.5×0.016PRKRA
obsolete protein kinase A signaling1175.5×0.016TTN
peptide cross-linking1175.5×0.016DSP
cardiac muscle tissue morphogenesis1175.5×0.016TTN

Therapeutics

Drug target analysis

Approved (phase 4): 0 · Phase ≥3: 0 · Phased (≥1): 0 · Undrugged: 11

Druggability breadth: 3 of 11 evidence-associated genes (27%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).

Top cohort targets by molecule count

SymbolMoleculesMax phase
TTN00
PLEKHA300
CORIN00
CCDC14100
DSP00
FKBP700
TTN-AS100
CYLD-AS100
LRP400
PMS200

Bioactivity and enzyme data

Enzyme cohort genes (≥1 EC): 1.

Cohort genes with ChEMBL bioactivity (full, sorted by assay count)

SymbolAssaysType breakdown
DSP2Binding:2
TTN1Binding:1
PMS21Binding:1

Cohort enzymes (BRENDA EC)

SymbolEC numbersNames
TTN2.7.11.1non-specific serine/threonine protein kinase

Pharmacogenomics

Cohort genes with a PharmGKB record: 9; with CPIC/DPWG dosing guidelines: 0.

No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).

Chemical tractability of cohort targets

0 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.

Druggability pyramid

Cohort genes binned by druggability tier (high → low):

TierDefinitionGenesSymbols
AApproved (phase 4 drug)0
BPhased (≥1) drug, not yet approved0
CDruggable family + PDB, no drug1TTN
DDruggable family + AlphaFold only, no drug2CORIN, CCDC141
EDifficult family or no structure, no drug8PLEKHA3, DSP, FKBP7, TTN-AS1, CYLD-AS1, LRP4, PMS2, PRKRA

Undrugged target profiles

11 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).

SymbolChEMBL assaysDrugged partners (top 3)
TTN1
PLEKHA30
CORIN0
CCDC1410
DSP2
FKBP70
TTN-AS10
CYLD-AS10
LRP40
PMS21
PRKRA0

Clinical trials & evidence

Clinical trials

Clinical trials: 0.