PROJECT SUMMARY/ABSTRACT
Electrocardiographic QT interval, an index of ventricular repolarization, is a clinically relevant heritable
quantitative trait associated with risk for cardiac arrhythmias and sudden cardiac death (SCD). Genetic studies
in subjects with rare Mendelian long- and short-QT syndromes have identified rare, severe coding mutations in
~20 genes encoding voltage-gated ion channels, transporters and associated proteins that regulate cardiac action
potential duration (APD) or excitation-contraction (EC) coupling. Prevalence of coding polymorphisms in these
genes affecting population repolarization variability is extremely low. In contrast, genome-wide association
studies (GWAS) of QT interval in the general population have identified common, noncoding variants at nearly
three dozen loci, collectively explaining ~20% of the additive variance. Nearly half of these GWAS loci harbor
genes known to regulate cardiac APD or EC coupling, thus serving as the likely causal genes. Nonetheless, the
identities of the actual causal genes and molecular mechanisms underlying associations with the common and,
largely noncoding variants at these loci, remain unknown. Moreover, a large fraction (~80%) of the additive
variance remains unidentified. Leveraging information on known genes, in the proposed studies we will address
these gaps in our knowledge based on the hypotheses that a) multiple common variants that impact the activities
of several cis-regulatory elements (CREs) underlie a GWAS signal by collectively influencing the expression of a
target gene, and b) genes underlying specific or similar diseases/traits are often functionally related, and that
functionally related genes often belong to gene regulatory networks (GRNs), members of which are co-regulated.
We aim to functionally characterize selected QT interval GWAS loci with a priori evidence for likely causal genes
as well as extend gene discovery by assessing the impacts of perturbing the expression of known QT interval
genes on their GRNs. Our specific aims are: (1) identification of functional CRE variants at selected QT interval
GWAS loci by evaluating all trait-associated common variants overlapping cardiac open chromatin regions in
high-throughput reporter assays in mouse cardiomyocyte HL1 cells; and to link CREs and their variants to
putative target genes based on expression quantitative trait locus and chromatin contact analyses in human adult
left ventricle tissue and induced pluripotent stem cells-derived cardiomyocytes (hiPSC-CMs); and (2) performing
CRISPR activation/interference-based expression perturbations of selected QT interval genes in neonatal rat
ventricular myocytes (NRVMs), and assessing transcriptome-wide effects to identify candidate co-regulated gene
sets; evaluating the co-regulated gene sets for enrichment in sub-threshold GWAS loci; overlapping co-regulated
genes with QT GWAS loci to identify likely causal genes; and assessing the impact of perturbing expression of
newly identified genes on cellular electrophysiology in NRVMs and hiPSC-CMs. Together, the proposed studies
are expected to lead to a better understanding of the molecular mechanisms underlying QT interval variation
and SCD risk, and serve as a model for functional characterization of GWAS loci of complex diseases and traits.