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Viswanathan S, Sandeep Oza P, Bellad A, Uttarilli A. Conotruncal Heart Defects: A Narrative Review of Molecular Genetics, Genomics Research and Innovation. OMICS : A JOURNAL OF INTEGRATIVE BIOLOGY 2024; 28:324-346. [PMID: 38986083 DOI: 10.1089/omi.2024.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Congenital heart defects (CHDs) are most prevalent cardiac defects that occur at birth, leading to significant neonatal mortality and morbidity, especially in the developing nations. Among the CHDs, conotruncal heart defects (CTDs) are particularly noteworthy, comprising a significant portion of congenital cardiac anomalies. While advances in imaging and surgical techniques have improved the diagnosis, prognosis, and management of CTDs, their molecular genetics and genomic substrates remain incompletely understood. This expert review covers the recent advances from January 2016 onward and examines the complexities surrounding the genetic etiologies, prevalence, embryology, diagnosis, and clinical management of CTDs. We also emphasize the known copy number variants and single nucleotide variants associated with CTDs, along with the current planetary health research efforts aimed at CTDs in large cohort studies. In all, this comprehensive narrative review of molecular genetics and genomics research and innovation on CTDs draws from and highlights selected works from around the world and offers new ideas for advances in CTD diagnosis, precision medicine interventions, and accurate assessment of prognosis and recurrence risks.
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Affiliation(s)
- Sruthi Viswanathan
- Institute of Bioinformatics, Bengaluru, Bangalore, Karnataka, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Prachi Sandeep Oza
- Institute of Bioinformatics, Bengaluru, Bangalore, Karnataka, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anikha Bellad
- Institute of Bioinformatics, Bengaluru, Bangalore, Karnataka, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anusha Uttarilli
- Institute of Bioinformatics, Bengaluru, Bangalore, Karnataka, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
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Hu D, Lan T, Chen Y, Chen L, Li J, Sun X, Chen H, Fang J. An 18-year evolution of congenital heart disease in China: An echocardiographic database-based study. Int J Cardiol 2023; 391:131286. [PMID: 37619874 DOI: 10.1016/j.ijcard.2023.131286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/20/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE Data on the evolution of congenital heart disease (CHD) in China remain scarce. Based on a Chinese echocardiography database, we analyzed the observed rate (OR) and spectrum changes of CHD over the past 18 years with a focus on the congenital aortic valve malformation (CAVM) and Adult CHD (ACHD). METHODS AND RESULTS The transthoracic echocardiographic data of 682,565 records from 2003 to 2020 were retrospectively reviewed at Fujian Medical University Union Hospital, China. A total of 37,200 CHD cases were recruited in this study. Over the three periods (from 2003 to 2008, 2009-2014, to 2015-2020), the OR of Total CHD decreased (106.72, 90.64, and 67.43 per 1000 cases, respectively); the proportion of Simple CHD to Total CHD increased (80.96%, 83.41%, and 87.97%, respectively), with a decrease in the proportion of Complex CHD (18.11%, 15.51%, and 10.42%, respectively) (p < 0.05 for all). The proportion of ACHD increased in most types of CHD [Total CHD: 25.79%, 27.84%, and 31.43%; CAVM: 69.02%, 73.42%, and 78.16%; CAVM with aortic stenosis (AS): 67.42%, 70.73%, and 79.25%; respectively, p < 0.05 for all], with a much higher proportion in both CAVM and CAVM with AS than in the other CHD types. The proportion of CHD patients receiving intervention increased over the designated periods. CONCLUSIONS This study depicts the longitudinal changes of CHD in the Chinese population with a single-center echocardiographic data, revealing an increased proportion of Simple CHD, ACHD (including CAVM and CAVM with AS), and a decreased OR of Total CHD and proportion of Complex CHD.
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Affiliation(s)
- DanQing Hu
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China; School of Health, Fujian Medical University, Fuzhou, PR China
| | - TingXiang Lan
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China; Department of Ultrasound, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, PR China
| | - YiFan Chen
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, PR China
| | - LinYan Chen
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China
| | - JinGuo Li
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China
| | - XuDong Sun
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China
| | - Hua Chen
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China
| | - Jun Fang
- Department of Cardiology, Fujian Medical University Union Hospital, Fujian Cardiovascular Medical Center, Fujian Institute of Coronary Artery Disease, Fujian Cardiovascular Research Center, Fuzhou, PR China.
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Zhou Y, Yang D, Mao X, Zhou H, Wang L. Epidemiology of birth defects in a national hospital-based birth defect surveillance spot in Southern Jiangsu, China, 2014-2018. Front Med (Lausanne) 2023; 10:1138946. [PMID: 37766918 PMCID: PMC10520965 DOI: 10.3389/fmed.2023.1138946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 08/09/2023] [Indexed: 09/29/2023] Open
Abstract
Objective As the only hospital-based national surveillance spot of birth defects (BDs) in Changzhou city located in the economically developed eastern part of China, Changzhou Maternal and Child Health Care Hospital has encountered serious challenges in BD prevention. This study aimed to describe the epidemiology of total BDs born in the hospital from 2014 to 2018. Methods The data were collected from the national hospital-based birth defect surveillance system. BD prevalence was calculated by Poisson distribution. Trends of prevalence and the associations regarding information with BDs were analyzed by Poisson regression. Results The reported prevalence of total BDs was 313.92 (95% confidence interval [CI]: 299.59-328.76) per 10,000 perinatal infants (PIs), while the perinatal prevalence of BD was 160.19 (95% CI: 150.00-170.89) per 10,000 PIs. A remarkable uptrend in the prevalence of BDs was noticed with a prevalence rate ratio (PRR) of 1.09 (95% CI: 1.04-1.14) and 1.13 (95% CI: 1.09-1.16), respectively. Congenital heart disease (CHD), cleft lip with or without cleft palate (CL/P), congenital malformation of the kidney (CMK), polydactyly, Down syndrome (DS), cystic hygroma, neural tube defect (NTD), and congenital talipes equinovarus (CTE) were common types of total BDs. Mothers living in the urban area (PRR = 1.67, 95% CI:1.50-1.87), male fetuses (PRR = 1.16, 95% CI: 1.05-1.28), and maternal age younger than 20 (PRR = 2.28, 95% CI: 1.60-3.25) and 25 years (PRR = 1.41, 95% CI: 1.22-1.63) or older than 35 years (PRR = 1.18, 95% CI: 1.00-1.40) were risk factors for BD occurrence. Conclusion The reported prevalence of total BDs was nearly two times higher than the perinatal prevalence of BDs in PIs, and the ranks of total BDs and BDs in PIs were different. Mothers living in the urban area, male fetuses, and maternal ages younger than 25 or older than 35 years were risk factors for BD incidence. Thus, improving prenatal examination technology, expanding the surveillance time quantum of BDs, and keeping maternal health may be warranted.
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Affiliation(s)
- Ying Zhou
- Department of Health Emergency, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Di Yang
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
| | - Xueqin Mao
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
| | - Hua Zhou
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
| | - Li Wang
- Department of Obstetrics and Gynecology, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Nanjing, China
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Song L, Wang Y, Wang H, Wang G, Ma N, Meng Q, Zhu K, Hu S, Zhou G, Feng Z. Clinical profile of congenital heart diseases detected in a tertiary hospital in China: a retrospective analysis. Front Cardiovasc Med 2023; 10:1131383. [PMID: 37745117 PMCID: PMC10514906 DOI: 10.3389/fcvm.2023.1131383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Background Congenital heart diseases (CHDs) are conditions that involve structural problems to the heart's structure existing at birth, with an incidence of approximately 8 per 1,000 live births globally. CHD is one of the leading causes of maternal, fetal, and neonatal morbidity and mortality worldwide. The present study sought to examine the clinical profiles of CHD patients and provide important implications for therapeutic interventions. Methods This was a retrospective, observational, cohort study. The medical records of all CHDs patients aged between 0 and 18 years were collected from July 1, 2021 to June 30, 2022. Clinical profiles and demographic data were collected from cardiology and pediatric department registers for analysis. Results Of the 265 children with CHDs, 201 were diagnosed with acyanotic CHD (ACHD), while 64 children had cyanotic CHD (CCHD). Based on the eleventh revision of the International Classification of Diseases (ICD-11), "congenital anomaly of a ventricle or the ventricular septum" was the most common CHD. The most common symptom was failure to thrive, accounting for 18.5% of all CHD cases. The most frequent symptom in ACHD was murmur (93.53%) and sweating (80.60%), whereas the most common symptom in CCHD was sweating (95.31%) and cyanosis (84.38%). Conclusions This study retrospectively analyzed CHD clinical characteristics from children receiving care at the seventh center, which forms a proper basis for appropriate clinical treatments and further studies.
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Affiliation(s)
- Linhong Song
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Yi Wang
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Hui Wang
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Gang Wang
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Ning Ma
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Qiang Meng
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Kunao Zhu
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Siqi Hu
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Gengxu Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
| | - Zhichun Feng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Department of Pediatric Cardiac Surgery, Faculty of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- Institute of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
- National Engineering Laboratory for Birth Defects Prevention and Control of Key Technology, Beijing, China
- Beijing Key Laboratory of Pediatric Organ Failure, Beijing, China
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Madruga I, Moraes TDD, Prado C, Baldini CES, Braga ALF. Associated Factors with Congenital Heart Disease in the Most Populated State of Brazil Between 2010 and 2018. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2023. [DOI: 10.36660/ijcs.20210283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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Possible Association of Pulmonary Atresia with In-Utero Coxsackievirus B Exposure. Pediatr Cardiol 2022; 43:960-968. [PMID: 35022808 PMCID: PMC8754073 DOI: 10.1007/s00246-021-02805-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/09/2021] [Indexed: 11/07/2022]
Abstract
Gestational viral infection has been associated with congenital heart disease (CHD). Few studies, however, have studied the potential role of gestational Coxsackievirus B (CVB) exposure in the pathogenesis of CHD. We prospectively enrolled women with pregnancies affected by CHD to explore possible associations with in utero CVB exposure. Serum samples were obtained from 122 women referred for fetal echocardiography between 2006 and 2018. We quantified CVB IgG and IgM levels, with titers ≥ 15.0 U/mL considered positive and measured neutralizing antibodies for three CVB serotypes: CVB1, CVB3, and CVB4. Using data from the national enterovirus surveillance system, we compared the annual exposure rates for each serotype in our cohort to infections reported across the United States. 98 pregnancies with no genetic defects were included. Overall, 29.6% (29/98) had positive IgG and 4.1% (4/98) of women had positive CVB IgM titers. To explore first-trimester CVB exposure, we focused exclusively on the 26 women with positive IgG and negative IgM titers. 61.5% (16/26) had neutralizing antibodies against a single serotype and 38.5% (10/26) against multiple CVB serotypes. CVB4 neutralizing antibodies were the most common (65.4%, 17/26), followed by CVB3 (53.9%, 14/26) and CVB1 (30.8%, 8/26). Among these, 30.8% of babies presented pulmonary valve anomalies: 19.2% (5/26) pulmonary atresia, and 11.5% (3/26) pulmonary stenosis. 23.1% (6/26) of babies had coronary sinusoids. CVB exposure in our cohort mirrored that of reported infections in the United States. Our results suggest a possible association between gestational CVB exposure and specific CHD, particularly pulmonary valve anomalies and coronary sinusoids.
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Animasahun B, Ajayi O, Lamina M, Kehinde A. Pulmonary atresia with intact ventricular septum (PAIVS): Is Nigeria ready for this complex disorder? INTERNATIONAL JOURNAL OF CARDIOLOGY CONGENITAL HEART DISEASE 2021. [DOI: 10.1016/j.ijcchd.2021.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Agostini CDO, Poloni S, Barbiero SM, Vian I. Prevalence of breastfeeding in children with congenital heart diseases and down syndrome. Clin Nutr ESPEN 2021; 44:458-462. [PMID: 34330505 DOI: 10.1016/j.clnesp.2021.03.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/07/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND According to the World Health Organization, the worldwide incidence of Down syndrome is one in a thousand live births a year. Of these, it is estimated that 20-60% have congenital heart disease, a factor that hinders breastfeeding. Considering the numerous benefits of breastfeeding, a study verifying this prevalence in children with Down syndrome and congenital heart disease is indispensable, and this is not yet evidenced in the literature. The aim of this study is to verify the prevalence of breastfeeding in children with Down syndrome and congenital heart disease admitted to a referral hospital in cardiology. METHODS Cross-sectional study with 62 patients, aged between 0 and 5 years. Anthropometric variables (weight, height) and data related to breastfeeding were collected. Statistical analysis was performed using the SPSS® version 26.0 statistical software. RESULTS The prevalence of breastfeeding was of 80.6%, but the median of exclusive breastfeeding was of only 3 days. Only 38.7% received breastfeeding for more than 6 months. The main reasons for interruption were difficulty in sucking and tiredness to breastfeed. Statistical significance was evidenced when comparing the time of exclusive breastfeeding and maintenance with the mother's education, with p = 0.006 and p = 0.041, respectively. No relationship was found between nutritional status and breastfeeding. CONCLUSIONS Despite the high prevalence of breastfeeding, the maintenance time is well below the recommendations. Therefore, further monitoring and promotion of breastfeeding is necessary for this population, given the countless benefits of breast milk.
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Affiliation(s)
- Clarissa de Oliveira Agostini
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Soraia Poloni
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Sandra Mari Barbiero
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Izabele Vian
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.
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Ekure EN, Adeyemo A, Liu H, Sokunbi O, Kalu N, Martinez AF, Owosela B, Tekendo-Ngongang C, Addissie YA, Olusegun-Joseph A, Ikebudu D, Berger SI, Muenke M, Han Z, Kruszka P. Exome Sequencing and Congenital Heart Disease in Sub-Saharan Africa. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2021; 14:e003108. [PMID: 33448881 DOI: 10.1161/circgen.120.003108] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Congenital heart disease (CHD) is the most common birth defect and affects roughly 1% of the global population. There have been many large CHD sequencing projects in developing countries but none in sub-Saharan Africa. In this exome sequencing study, we recruited families from Lagos, Nigeria, affected by structural heart disease. METHODS Ninety-eight participants with CHD and an average age of 3.6 years were recruited from Lagos, Nigeria. Exome sequencing was performed on probands and parents when available. For genes of high interest, we conducted functional studies in Drosophila using a cardiac-specific RNA interference-based gene silencing system. RESULTS The 3 most common CHDs were tetralogy of Fallot (20%), isolated ventricular septal defect (14%), and transposition of the great arteries (8%). Ten percent of the cohort had pathogenic or likely pathogenic variants in genes known to cause CHD. In 64 complete trios, we found 34 de novo variants that were not present in the African population in the Genome Aggregation Database (v3). Nineteen loss of function variants were identified using the genome-wide distribution of selection effects for heterozygous protein-truncating variants (shet). Nine genes caused a significant mortality when silenced in the Drosophila heart, including 4 novel disease genes not previously associated with CHD (UBB, EIF4G3, SREBF1, and METTL23). CONCLUSIONS This study identifies novel candidate genes and variants for CHD and facilitates comparisons with previous CHD sequencing studies in predominantly European cohorts. The study represents an important first step in genomic studies of CHD in understudied populations. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01952171.
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Affiliation(s)
- Ekanem N Ekure
- Department of Pediatrics (E.N.E., O.S., N.K.), College of Medicine, University of Lagos/Lagos University Teaching Hospital, Nigeria
| | | | - Hanhan Liu
- Center for Precision Disease Modeling, University of Maryland School of Medicine, Baltimore (H.L., Z.H.)
| | - Ogochukwu Sokunbi
- Department of Pediatrics (E.N.E., O.S., N.K.), College of Medicine, University of Lagos/Lagos University Teaching Hospital, Nigeria
| | - Nnenna Kalu
- Department of Pediatrics (E.N.E., O.S., N.K.), College of Medicine, University of Lagos/Lagos University Teaching Hospital, Nigeria
| | - Ariel F Martinez
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda (A.F.M., B.O., C.T.-N., Y.A.A., M.M., P.K.)
| | - Babajide Owosela
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda (A.F.M., B.O., C.T.-N., Y.A.A., M.M., P.K.)
| | - Cedrik Tekendo-Ngongang
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda (A.F.M., B.O., C.T.-N., Y.A.A., M.M., P.K.)
| | - Yonit A Addissie
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda (A.F.M., B.O., C.T.-N., Y.A.A., M.M., P.K.)
| | - Akinsanya Olusegun-Joseph
- Department of Medicine (A.O.-J.), College of Medicine, University of Lagos/Lagos University Teaching Hospital, Nigeria
| | - Desmond Ikebudu
- Central Research Laboratory, College of Medicine, University of Lagos, Idi-Araba, Nigeria (D.I.)
| | - Seth I Berger
- Center for Genetic Medicine Research, Children's National Research Institute, Washington, DC (S.I.B.)
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda (A.F.M., B.O., C.T.-N., Y.A.A., M.M., P.K.)
| | - Zhe Han
- Center for Precision Disease Modeling, University of Maryland School of Medicine, Baltimore (H.L., Z.H.)
| | - Paul Kruszka
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda (A.F.M., B.O., C.T.-N., Y.A.A., M.M., P.K.)
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BVES downregulation in non-syndromic tetralogy of fallot is associated with ventricular outflow tract stenosis. Sci Rep 2020; 10:14167. [PMID: 32843646 PMCID: PMC7447802 DOI: 10.1038/s41598-020-70806-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 08/04/2020] [Indexed: 11/14/2022] Open
Abstract
BVES is a transmembrane protein, our previous work demonstrated that single nucleotide mutations of BVES in tetralogy of fallot (TOF) patients cause a downregulation of BVES transcription. However, the relationship between BVES and the pathogenesis of TOF has not been determined. Here we reported our research results about the relationship between BVES and the right ventricular outflow tract (RVOT) stenosis. BVES expression was significantly downregulated in most TOF samples compared with controls. The expression of the second heart field (SHF) regulatory network genes, including NKX2.5, GATA4 and HAND2, was also decreased in the TOF samples. In zebrafish, bves knockdown resulted in looping defects and ventricular outflow tract (VOT) stenosis, which was mostly rescued by injecting bves mRNA. bves knockdown in zebrafish also decreased the expression of SHF genes, such as nkx2.5, gata4 and hand2, consistent with the TOF samples` results. The dual-fluorescence reporter system analysis showed that BVES positively regulated the transcriptional activity of GATA4, NKX2.5 and HAND2 promoters. In zebrafish, nkx2.5 mRNA partially rescued VOT stenosis caused by bves knockdown. These results indicate that BVES downregulation may be associated with RVOT stenosis of non-syndromic TOF, and bves is probably involved in the development of VOT in zebrafish.
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Thomford NE, Biney RP, Okai E, Anyanful A, Nsiah P, Frimpong PG, Boakye DO, Adongo CA, Kruszka P, Wonkam A. Clinical Spectrum of congenital heart defects (CHD) detected at the child health Clinic in a Tertiary Health Facility in Ghana: a retrospective analysis. JOURNAL OF CONGENITAL CARDIOLOGY 2020. [DOI: 10.1186/s40949-020-00034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Congenital heart defects (CHD) are the singular most common congenital anomalies and account for a significant fraction of childhood mortality and morbidity. CHD occurs in ~ 1% of livebirths globally and often requires surgical interventions to improve quality of life and survival of patients. The prevalence and clinical presentations of CHD within specific populations provide a clearer overview of the burden of CHD and informs appropriate interventions. However, there is limited data on clinical presentation and occurrence of CHD in African countries such as Ghana where most cases are either diagnosed late or missed entirely resulting in increased mortality. In this retrospective study, we assessed the clinical presentations, associated comorbidities, and prescription patterns of diagnosed CHD in a tertiary facility in Ghana.
Method
This retrospective study utilized data from electronic health records (EHR) from the child health clinic of the Cape Coast Teaching Hospital - a tertiary health facility in Ghana from January 2018 to October 2019. All suspected or provisionally diagnosed cases including those confirmed with echocardiography were included in our analysis.
Results
Over 10, 000 records were reviewed, CHD was diagnosed in 79 cases, and 51 cases had complete clinical records including the type of CHD and clinical presentation. Male to female ratio was approximately 1:1 and 77.2% of the diagnoses were in children below 5 years. Acyanotic congenital heart defects were most commonly diagnosed with ventricular septal defects (VSD) and patent ductus arteriosus (PDA) being the simplest singular CHD. Tetralogy of Fallot, was the most common complex CHD accounting for 25.5% (13) of cases. Bronchopneumonia, upper respiratory infections and pneumonia were the most commonly diagnosed comorbidities accounting for over 35% of non-cardiac sequalae based on antibiotic and diuretic use.
Conclusion
Our study showed that over 75% of CHD cases were diagnosed under 5 years with VSD and TOF being the most commonly diagnosed acyanotic and cyanotic lesions, respectively. This study presents preliminary data that give an overview of CHD burden in Ghana that will inform future research and appropriate interventions.
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Major birth defects in the Brazilian side of the triple border: a population-based cross-sectional study. ACTA ACUST UNITED AC 2020; 78:61. [PMID: 32617160 PMCID: PMC7325680 DOI: 10.1186/s13690-020-00443-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022]
Abstract
Background Major birth defects increase the risk of fetal death and pediatric hospitalization, which also impact on healthcare costs. Sociodemographic factors can drastically affect reproductive health and be used to discriminate the exposure to hidden risk factors. Foz do Iguassu is a Brazilian city located in the triple-border region of Brazil / Paraguay / Argentina with high rates of birth defects. However no study aimed to verify factors associated with this incidence or preventive care is reported. The current work investigated the prevalence of major birth defects and its association with maternal sociodemographic factors in Foz do Iguassu. Methods In this population-based cross-sectional study we used data of all live births occurred in Foz do Iguassu from 2012 to 2017. The associated sociodemographic variables such as maternal age, maternal education, maternal race, country of residence, maternal parity and onset of prenatal care were analyzed. Each major birth defect was described according to absolute and relative frequencies, Kruskal-Wallis and logistic regression models were used to evaluate variables associated with selected birth defects. Results The most prevalent major birth defects were Cleft Lip and/or Palate (9.5/10,000), gastroschisis (6.93/10,000), spina bifida (5.53/10,000), hydrocephalus (5.53/10,000), hypospadias (4.55/10,000), Down syndrome (4.23/10,000), anencephaly (2.93/10,000), anorectal atresia / stenosis (1.95/10,000), undetermined sex (1.95/10,000), esophageal atresia / stenosis with or without fistula (1.63/10,000) and limb reduction defects (1.30/10,000). Maternal age was associated with gastroschisis and Down syndrome. Only maternal education up to 7 years was statistically associated with major birth defects considering all other sociodemographic variables. Conclusion Cleft Lip and/or Palate and Gastroschisis prevalence were higher than those found in the literature. This findings may suggest a distinct epidemiological behavior regarding major birth defects in the region. The work opens new perspectives for birth defects risk factors in the triple-border.
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Jerves T, Beaton A, Kruszka P. The genetic workup for structural congenital heart disease. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2019; 184:178-186. [PMID: 31833661 DOI: 10.1002/ajmg.c.31759] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 12/19/2022]
Abstract
Congenital heart disease (CHD) is the most prevalent birth defect and is the result of multiple etiologies including genetic and environmental causes. This article reviews the genetic workup for structural CHD in the clinical setting, beginning with CHD epidemiology and etiology and then moving to genetic testing, clinical evaluation, and genetic counseling. An algorithm is presented as a guide to genetic test selection, and available tests are explained with their respective advantages and limitations. Finally, future advances are discussed. As this review focuses on structural heart disease, isolated cardiomyopathies, inherited primary arrhythmia syndromes and aortopathies are not discussed.
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Affiliation(s)
- Teodoro Jerves
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Andrea Beaton
- Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Paul Kruszka
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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Pan J, Hu J, Qi X, Xu L. Association study of a functional variant of TNF-α gene and serum TNF-α level with the susceptibility of congenital heart disease in a Chinese population. Postgrad Med J 2019; 95:547-551. [PMID: 31324728 DOI: 10.1136/postgradmedj-2019-136621] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/31/2019] [Accepted: 06/23/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Congenital heart disease (CHD) is among the leading causes of infant death worldwide. Although shortage of folate has been found potentially to contribute to CHD in the embryo, the aetiology of CHD was not completely understood. Inflammation and altered immune processes are involved in all forms of cardiac malformation, including CHD. Tumour necrosis factor-α (TNF-α), was involved in the pathogenesis of multiple kinds of heart diseases. However, no studies have systematically evaluated the associations of genetic variants of TNF-α with susceptibility of CHD. METHODS A case-control study was conducted to evaluate the associations between tagSNPs of TNF-α and CHD susceptibility. Serum level of TNF-α was assessed using ELISA. The dual luciferase reporter assay was used to evaluate the functional significance of variant rs1800629 on TNF-α transcriptional activity. RESULTS We found rs1800629 was significantly correlated with increased CHD susceptibility (OR: 1.72, 95% CI 1.26 to 2.36, p=0.001). Serum levels of TNF-α were significantly higher in CHD group (9.09±1.90 pg/mL) than that in control group (6.12±1.56 pg/mL, p<0.001). The AA genotype and AG genotype of rs1800629 was associated with higher serum TNF-α level, compared with GG genotype. The dual luciferase reporter assay showed that promoter activity was significantly increased by 57% and 76% for plasmids containing the minor A allele compared with the major G allele in H9c2 and HEK 293T, respectively. CONCLUSION These results indicate that higher level of serum TNF-α increases risk of CHD, while TNF-α rs1800629 A allele might contribute to higher risk for CHD due to the increase in TNF-α expression.
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Affiliation(s)
- Jun Pan
- Pediatrics, Taihe Hospital, Shiyan, China
| | - Jiang Hu
- Oncology, Taihe Hospital, Shiyan, China
| | - Xusheng Qi
- Pediatrics, Taihe Hospital, Shiyan, China
| | - Liqin Xu
- Pediatrics, Taihe Hospital, Shiyan, China
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