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Van Praagh R. Interatrial Communications. CONGENIT HEART DIS 2022. [DOI: 10.1016/b978-1-56053-368-9.00009-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ellesøe SG, Workman CT, Bouvagnet P, Loffredo CA, McBride KL, Hinton RB, van Engelen K, Gertsen EC, Mulder BJM, Postma AV, Anderson RH, Hjortdal VE, Brunak S, Larsen LA. Familial co-occurrence of congenital heart defects follows distinct patterns. Eur Heart J 2019; 39:1015-1022. [PMID: 29106500 PMCID: PMC6018923 DOI: 10.1093/eurheartj/ehx314] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 06/01/2017] [Indexed: 12/16/2022] Open
Abstract
Aims Congenital heart defects (CHD) affect almost 1% of all live born children and the number of adults with CHD is increasing. In families where CHD has occurred previously, estimates of recurrence risk, and the type of recurring malformation are important for counselling and clinical decision-making, but the recurrence patterns in families are poorly understood. We aimed to determine recurrence patterns, by investigating the co-occurrences of CHD in 1163 families with known malformations, comprising 3080 individuals with clinically confirmed diagnosis. Methods and results We calculated rates of concordance and discordance for 41 specific types of malformations, observing a high variability in the rates of concordance and discordance. By calculating odds ratios for each of 1640 pairs of discordant lesions observed between affected family members, we were able to identify 178 pairs of malformations that co-occurred significantly more or less often than expected in families. The data show that distinct groups of cardiac malformations co-occur in families, suggesting influence from underlying developmental mechanisms. Analysis of human and mouse susceptibility genes showed that they were shared in 19% and 20% of pairs of co-occurring discordant malformations, respectively, but none of malformations that rarely co-occur, suggesting that a significant proportion of co-occurring lesions in families is caused by overlapping susceptibility genes. Conclusion Familial CHD follow specific patterns of recurrence, suggesting a strong influence from genetically regulated developmental mechanisms. Co-occurrence of malformations in families is caused by shared susceptibility genes.
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Affiliation(s)
- Sabrina G Ellesøe
- Programme for Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Christopher T Workman
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Patrice Bouvagnet
- Laboratoire Cardiogénétique, Hospices Civils de Lyon, Groupe Hospitalier Est, 59 boulevard Pinel, CBPE, 69677, Bron, France
| | - Christopher A Loffredo
- Department of Oncology, Georgetown University Medical Center, 3970 Reservoir Road, Washington, DC 20057-1472, USA
| | - Kim L McBride
- Center for Cardiovascular Research, Nationwide Children's Hospital, and Department of Pediatrics, Ohio State University, 700 Children's Drive Columbus, OH 43205, Columbus, OH, USA
| | - Robert B Hinton
- Division of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45229, USA
| | - Klaartje van Engelen
- Department of Clinical Genetics, Academic Medical Centre, Meibergdreef 15, Amsterdam 1105 AZ, The Netherlands.,Department of Clinical Genetics, VU University, De Boelelaan 1117, NL-1081 HV Amsterdam, The Netherlands
| | - Emma C Gertsen
- Department of Clinical Genetics, Academic Medical Centre, Meibergdreef 15, Amsterdam 1105 AZ, The Netherlands
| | - Barbara J M Mulder
- Department of Cardiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Alex V Postma
- Department of Clinical Genetics, Academic Medical Centre, Meibergdreef 15, Amsterdam 1105 AZ, The Netherlands.,Department of Anatomy, Embryology & Physiology, Academic Medical Centre, Meibergdreef 15, Amsterdam 1105 AZ, The Netherlands
| | - Robert H Anderson
- Institute of Genetic Medicine, Newcastle University, Central Pkwy, Newcastle upon Tyne NE1 3BZ, UK
| | - Vibeke E Hjortdal
- Department of Cardiothoracic Surgery, Aarhus University Hospital, Skejby, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Søren Brunak
- Programme for Disease Systems Biology, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
| | - Lars A Larsen
- Wilhelm Johannsen Centre for Functional Genome Research, Department of Cellular and Molecular Medicine, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark
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Aoki H, Horie M. Electrical disorders in atrial septal defect: genetics and heritability. J Thorac Dis 2018; 10:S2848-S2853. [PMID: 30305944 DOI: 10.21037/jtd.2018.02.53] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Atrial septal defect (ASD) is one of the most common types of congenital heart diseases (CHDs). Most ASDs occur sporadically, but some are inherited and associated with cardiac conduction defects such as atrioventricular block (AVB) or bundle branch block. Mutations in genes encoding transcription factor gene TBX5 and NKX2-5, were found in Holt-Oram syndrome (HOS) and ASD with atrioventricular (AV) conduction defects, respectively. HOS is characterized by upper limb anomaly in addition to ASD and AVB (heart-hand syndrome). ASD associated with NKX2-5 is rare but is reported to cause sudden cardiac death (SCD) or cardiomyopathy. We provide a review of these two diseases.
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Affiliation(s)
- Hisaaki Aoki
- Department of Pediatric Cardiology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Minoru Horie
- Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Ohtsu, Shiga, Japan
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Csáky-Szunyogh M, Vereczkey A, Urbán R, Czeizel AE. Risk and protective factors in the origin of atrial septal defect secundum--national population-based case-control study. Cent Eur J Public Health 2014; 22:42-7. [PMID: 24844106 DOI: 10.21101/cejph.a3824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of this study was to assess the risk factors in the origin of lethal or surgically corrected isolated atrial septal defect secundum. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities (conducted between 1980 and 1996) comprised 472 atrial septal defect secundum cases, 678 matched controls and 38,151 available controls without any defects; in addition, 21,022 malformed controls with other isolated defects. Medically recorded chronic disorders in the prenatal maternity logbook were evaluated, while acute maternal diseases, drug treatments and pregnancy supplements were analyzed on the basis of both prospective medically recorded data and retrospective maternal information. Acute pelvic inflammatory disease, paroxysmal supraventricular tachycardia and phenolphthalein treatment due to severe constipation of mothers were shown to contribute to the development of atrial septal defect secundum of their children. High doses of folic acid in early pregnancy had positively influenced a minor part of isolated atrial septal defect secundum in foetuses. In conclusion, the obvious genetic predisposition for atrial septal defect secundum is connected with maternal paroxysmal supraventricular tachycardia and triggered by acute pelvic inflammatory diseases and phenolphthalein treatment, while the manifestation of atrial septal defect secundum can be reduced by high doses of folic acid supplementation in early pregnancy.
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Al Akhfash AA, Al-Mesned A, Fayadh MA. Amplatzer septal occluder and atrioventricular block: A case report and literature review. J Saudi Heart Assoc 2013; 25:91-4. [PMID: 24174853 DOI: 10.1016/j.jsha.2013.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 01/02/2013] [Accepted: 01/12/2013] [Indexed: 11/26/2022] Open
Abstract
Transcatheter closure of secondum atrial septal defect (ASD) is an alternative option to open heart surgery with good short and long-term outcomes. For this purpose, the Amplatzer septal occluder (ASO) device is widely used. Arrhythmias are known complications of ASD device closure including atrial ectopy and heart block. We report a seven-year-old female patient who developed second degree atrioventricular block (AVB) within few hours after ASD device closure using ASO device. At the seventh post-procedure day; while under close observation; patient regained sinus rhythm which was maintained thereafter. A 3-day course of prednisolone was given.
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Affiliation(s)
- Ali A Al Akhfash
- Paediatric Cardiology, Prince Sultan Cardiac Canter Al-Qassim, P.O. Box 896, Qassim 51421 Saudi Arabia
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Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, Del Nido P, Fasules JW, Graham TP, Hijazi ZM, Hunt SA, King ME, Landzberg MJ, Miner PD, Radford MJ, Walsh EP, Webb GD. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2009; 52:e143-e263. [PMID: 19038677 DOI: 10.1016/j.jacc.2008.10.001] [Citation(s) in RCA: 977] [Impact Index Per Article: 65.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Mutations in mammalian tolloid-like 1 gene detected in adult patients with ASD. Eur J Hum Genet 2008; 17:344-51. [PMID: 18830233 DOI: 10.1038/ejhg.2008.175] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Atrial septal defect (ASD) is an incomplete septation of atria in human heart causing circulatory problems. Its frequency is estimated at one per 10 000. Actions of numerous genes have been linked to heart development. However, no single gene defect causing ASD has yet been identified. Incomplete heart septation similar to ASD was reported in transgenic mice with both inactive alleles of gene encoding mammalian zinc metalloprotease a mammalian tolloid-like 1 (tll1). Here, we have screened 19 ASD patients and 15 healthy age-matched individuals for mutations in TLL1 gene. All 22 exons were analyzed exon by exon for heteroduplex formation. Subsequently, DNA fragments forming heteroduplexes were sequenced. In four nonrelated patients, three missense mutations in coding sequence, and one single base change in the 5'UTR have been detected. Two mutations (Met182Leu, and Ala238Val) were detected in ASD patients with the same clinical phenotype. As the second mutation locates immediately upstream of the catalytic zinc-binding signature, it might change the enzyme substrate specificity. The third change, Leu627Val in the CUB3 domain, has been found in an ASD patient with interatrial septum aneurysm in addition to ASD. The CUB3 domain is important for substrate-specific recognition. In the remaining 15 patients as well as in 15 reference samples numerous base substitutions, deletions, and insertions have been detected, but no mutations changing the coding sequence have been found. Lack of mutations in relation to ASD of these patients could possibly be because of genetic heterogeneity of the syndrome.
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Adamopoulos S, Kokkinou S, Parissis JT, Kremastinos DT. New insight into "heart-hand" syndromes: a newly discovered chromosomal abnormality in a family with "heart-hand" syndrome. Int J Cardiol 2005; 97:129-32. [PMID: 15336819 DOI: 10.1016/j.ijcard.2004.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2004] [Accepted: 05/17/2004] [Indexed: 11/29/2022]
Abstract
Heart-hand syndromes are a genetic heterogeneous family of disorders, which are characterised by congenital cardiac and forelimb anomalies. We describe a deletion on chromosome 6, which seems to be connected to the phenotypic expression of a heart-hand syndrome in many affected members of a family who, in addition to the characteristic hypoplastic, manifested hyperplastic skeletal abnormalities. This newly discovered chromosomal abnormality confirms once more the genetic heterogeneity of the syndrome.
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Affiliation(s)
- Stamatis Adamopoulos
- Second Department of Cardiovascular Medicine, Onassis Cardiac Surgery Center, Riga Ferreou Str. 18-20, Maroussi 15122, Athens, Greece
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Affiliation(s)
- M E Brickner
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235-9047, USA
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Hebe J, Krings G, Hansen P, Volkmer M, Ouyang F, Kuck KH. [Arrhythmias in patients with congenital heart disease and their impact on prognosis]. Herz 1999; 24:315-34. [PMID: 10444710 DOI: 10.1007/bf03043882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with congenital heart disease have an increased chance to suffer from brady- as well as tachyarrhythmias. The impact of these on quality of life, morbidity and mortality is more often imperative as compared to heart-healthy individuals. The substrate for these may be either congenital or acquired. Improvements of the surgical management of these patients have led, on the one hand, to improved survival rates with prolonged life expectancy within the last 2 decades, which on the other hand provided the basis for a higher rate of acquired cardiac arrhythmias. Together, this not only challenges diagnostics and therapy but also the prognostic relevance of these arrhythmias. The therapeutic strategies and prognostic markers have until now mostly been based on retrospective studies limited by the low number of patients and inhomogeneous patient selection. Despite these limitations, an increased risk of sudden cardiac death has been substantiated for certain patient groups, e.g., those operated on by the Mustard- or Senning procedures in patients with transposition of the great arteries and patients operated on with correction of the tetralogy of Fallot. However, until now it has not been possible to identify reliable markers for establishing the risk on an individual basis within these patient cohorts. For achieving reliable data on the symptomatic and prognostic effects of present-day--as well as new-coming--therapeutic strategies, it is mandatory to perform prospectively based, randomized multicenter studies. Furthermore, the well-appreciated synergism of hemodynamically and primarily of arrhythmia-based effects on prognosis could potentially be divided into their relative weight to better guide appropriate, substrate-related therapy. In addition, this should help to get better estimates of the risk for sudden cardiac death in different, etiologically homogeneous, groups of patients with congenital heart disease.
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Affiliation(s)
- J Hebe
- Allgemeines Krankenhaus St. Georg, Hamburg.
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Schott JJ, Benson DW, Basson CT, Pease W, Silberbach GM, Moak JP, Maron BJ, Seidman CE, Seidman JG. Congenital heart disease caused by mutations in the transcription factor NKX2-5. Science 1998; 281:108-11. [PMID: 9651244 DOI: 10.1126/science.281.5373.108] [Citation(s) in RCA: 872] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Mutations in the gene encoding the homeobox transcription factor NKX2-5 were found to cause nonsyndromic, human congenital heart disease. A dominant disease locus associated with cardiac malformations and atrioventricular conduction abnormalities was mapped to chromosome 5q35, where NKX2-5, a Drosophila tinman homolog, is located. Three different NKX2-5 mutations were identified. Two are predicted to impair binding of NKX2-5 to target DNA, resulting in haploinsufficiency, and a third potentially augments target-DNA binding. These data indicate that NKX2-5 is important for regulation of septation during cardiac morphogenesis and for maturation and maintenance of atrioventricular node function throughout life.
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Affiliation(s)
- J J Schott
- Department of Genetics and Howard Hughes Medical Institute, Harvard Medical School, Boston, MA 02115, USA
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 37-1993. A 48-year-old woman with an atrial septal defect and pulmonary hypertension. N Engl J Med 1993; 329:864-72. [PMID: 8355746 DOI: 10.1056/nejm199309163291209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Bosi G, Sensi A, Calzolari E, Scorrano M. Familial atrial septal defect with prolonged atrioventricular conduction. AMERICAN JOURNAL OF MEDICAL GENETICS 1992; 43:641. [PMID: 1605267 DOI: 10.1002/ajmg.1320430334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Ferencz C, Boughman JA, Neill CA, Brenner JI, Perry LW. Congenital cardiovascular malformations: questions on inheritance. Baltimore-Washington Infant Study Group. J Am Coll Cardiol 1989; 14:756-63. [PMID: 2768723 DOI: 10.1016/0735-1097(89)90122-8] [Citation(s) in RCA: 108] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The Baltimore-Washington Infant Study, an epidemiologic investigation of congenital heart disease, searches for genetic and environmental risk factors. Among 2,102 infants with heart disease, 17.5% had a noncardiac abnormality of chromosomal or genetic origin, whereas among 2,328 control infants, only 0.7% had a genetic abnormality. Familial cardiovascular malformations encountered can be grouped into five distinct etiologic mechanisms. Single gene effects may be responsible for the specific histologic and biochemical changes in familial atrial septal defect with conduction disturbance and also in idiopathic ventricular hypertrophy. Left heart lesions showed familial concordance by the presumed morphogenetic mechanism of abnormal embryonic blood flow with phenotypes of varying severity. Pulmonary stenosis appeared with familial heritable disorders, as well as a partially concordant lesion with tetralogy of Fallot. Ventricular septal defect with transposition of the great arteries (one sibling pair) and with truncus arteriosus (two sibling pairs) indicate forme fruste expression of conotruncal defects. Endocardial cushion defect occurred with and without Down's syndrome in members of three families, suggesting inheritance of a defect affecting cellular migration. Heritable blood coagulopathies occurred in case families and not in control families. The associated of hemophilia and transposition, observed also by others, is extremely unlikely by chance and suggests genetic errors of endothelial cell function. The description of specific families from a population-based study emphasizes biologic questions on the nature of the inheritance of cardiovascular malformations.
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Affiliation(s)
- C Ferencz
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201
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Bharati S, Lev M. Conduction system in sudden unexpected death a considerable time after repair of atrial septal defect. Chest 1988; 94:142-8. [PMID: 3383625 DOI: 10.1378/chest.94.1.142] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The cause of sudden death in young people with congenital heart disease, months or years postoperatively following total surgical correction, is today unknown despite complete autopsy. This is a study of the conduction system in four cases of atrial septal defect of the fossa ovalis type (secundum) who died suddenly several months to years following surgical repair and who were living a normal life. The study suggests that changes in the sinoatrial node and its approaches produced by surgery aided by a pulling effect of a floppy mitral valve on the central fibrous body and hence, on the conduction system, and the unknown familial genetic arrhythmic effect on the conduction system contributed to the sudden death of these patients.
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Affiliation(s)
- S Bharati
- Department of Pathology, Deborah Heart and Lung Center, Browns Mills, NJ
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Abstract
The diagnosis of atrial septal defect was established in monozygotic twin females at age 63. Each patient mimicked a different acquired heart disease. One twin had congestive heart failure and atrial fibrillation and was diagnosed as having rheumatic mitral insufficiency. The other twin had atypical chest pain and systemic hypertension and was thought to have arteriosclerotic heart disease. In each case the correct diagnosis was made at cardiac catheterization. Although the same basic congenital heart lesion was present in both patients, the symptoms and findings differed. Symptomatic improvement was achieved by different therapeutic modalities. One patient had open heart surgery, while the other twin improved with medical therapy.
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Sobrino JA, de Lombera F, del Rio A, Plaza I, Maté I, Sotillo JL, Hernández-Lanchas C, Sobrino N. Atrioventricular nodal dysfunction in patients with atrial septal defect. Abnormalities of conduction and reciprocal rhythms. Chest 1982; 81:477-82. [PMID: 7067514 DOI: 10.1378/chest.81.4.477] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Electrophysiologic studies were performed in 17 unselected patients (mean age, 20 years) with atrial septal defect (ASD) of the ostium secundum type. In nine (52.9 percent) signs were found of atrioventricular (A-V) nodal dysfunction, in seven (41.1 percent) prolonged A-H interval, and in three (17.6 percent) prolonged effective refractory period of A-V node and in five (29.4 percent) A-V nodal tachycardia and reentry. Three of the four cases showed anterograde conduction (Ae-H interval) faster than retrograde conduction (H-A3 interval) during the tachycardia. In one patient with reentry a similar phenomenon was observed. In the remaining patient the conduction time was reversed (Ae-H longer than H-Ae). In two patients infrahisian and intrahisian block (first and second degree) with persistence of the tachycardia was observed. Patent or latent abnormalities in A-V node function are a frequent finding in patients with ASD. In the sinus node, any kind of significant abnormality can be found.
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Maron BJ, Borer JS, Lau SH, Damato AN, Scott LP, Epstein SE. Association of secundum atrial septal defect and atrioventricular nodal dysfunction. A genetically transmitted syndrome. BRITISH HEART JOURNAL 1978; 40:1293-9. [PMID: 718771 PMCID: PMC483566 DOI: 10.1136/hrt.40.11.1293] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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