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Xue H, Yu A, Chen L, Guo Q, Zhang L, Lin N, Chen X, Xu L, Huang H. Prenatal genetic diagnosis of fetuses with dextrocardia using whole exome sequencing in a tertiary center. Sci Rep 2024; 14:16266. [PMID: 39009665 PMCID: PMC11251054 DOI: 10.1038/s41598-024-67164-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/09/2024] [Indexed: 07/17/2024] Open
Abstract
To evaluate the genetic etiology of fetal dextrocardia, associated ultrasound anomalies, and perinatal outcomes, we investigated the utility of whole exome sequencing (WES) for prenatal diagnosis of dextrocardia. Fetuses with dextrocardia were prospectively collected between January 2016 and December 2022. Trio-WES was performed on fetuses with dextrocardia, following normal karyotyping and/or chromosomal microarray analysis (CMA) results. A total of 29 fetuses with dextrocardia were collected, including 27 (93.1%) diagnosed with situs inversus totalis and 2 (6.9%) with situs inversus partialis. Cardiac malformations were present in nine cases, extra-cardiac anomalies were found in seven cases, and both cardiac and extra-cardiac malformations were identified in one case. The fetal karyotypes and CMA results of 29 cases were normal. Of the 29 cases with dextrocardia, 15 underwent WES, and the other 14 cases refused. Of the 15 cases that underwent WES, clinically relevant variants were identified in 5/15 (33.3%) cases, including the diagnostic variants DNAH5, DNAH11, LRRC56, PEX10, and ZIC3, which were verified by Sanger sequencing. Of the 10 cases with non-diagnostic results via WES, eight (80%) chose to continue the pregnancies. Of the 29 fetuses with dextrocardia, 10 were terminated during pregnancy, and 19 were live born. Fetal dextrocardia is often accompanied by cardiac and extra-cardiac anomalies, and fetal dextrocardia accompanied by situs inversus is associated with a high risk of primary ciliary dyskinesia. Trio-WES is recommended following normal karyotyping and CMA results because it can improve the diagnostic utility of genetic variants of fetal dextrocardia, accurately predict fetal prognosis, and guide perinatal management and the reproductive decisions of affected families.
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Affiliation(s)
- Huili Xue
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China.
| | - Aili Yu
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Lingji Chen
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Qun Guo
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Lin Zhang
- Fujian Medical University, No. 88 Jiaotong Road, Cangshan District, Fuzhou City, 350001, Fujian Province, China
| | - Na Lin
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Xuemei Chen
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Liangpu Xu
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China.
| | - Hailong Huang
- Medical Genetic Diagnosis and Therapy Center, Fujian Key Laboratory for Prenatal Diagnosis and Birth Defect, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 18 Daoshan Road, Gulou District, Fuzhou City, 350001, Fujian Province, China.
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Carrasco D, Guedes-Martins L. Cardiac Axis in Early Gestation and Congenital Heart Disease. Curr Cardiol Rev 2024; 20:CCR-EPUB-137797. [PMID: 38279755 PMCID: PMC11071675 DOI: 10.2174/011573403x264660231210162041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/06/2023] [Accepted: 10/17/2023] [Indexed: 01/28/2024] Open
Abstract
Congenital heart defects represent the most common structural anomalies observed in the fetal population, and they are often associated with significant morbidity and mortality. The fetal cardiac axis, which indicates the orientation of the heart in relation to the chest wall, is formed by the angle between the anteroposterior axis of the chest and the interventricular septum of the heart. Studies conducted during the first trimester have demonstrated promising outcomes with respect to the applicability of cardiac axis measurement in fetuses with congenital heart defects as well as fetuses with extracardiac and chromosomal anomalies, which may result in improved health outcomes and reduced healthcare costs. The main aim of this review article was to highlight the cardiac axis as a reliable and powerful marker for the detection of congenital heart defects during early gestation, including defects that would otherwise remain undetectable through the conventional four-chamber view.
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Affiliation(s)
- D. Carrasco
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- Centro de Medicina Fetal, Medicina Fetal Porto, Serviço de Obstetrícia - Centro Materno Infantil do Norte, Porto 4099-001, Portugal
| | - L. Guedes-Martins
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- Centro de Medicina Fetal, Medicina Fetal Porto, Serviço de Obstetrícia - Centro Materno Infantil do Norte, Porto 4099-001, Portugal
- Centro Hospitalar Universitário do Porto EPE, Centro Materno Infantil do Norte, Departamento da Mulher e da Medicina Reprodutiva, Largo Prof. Abel Salazar, 4099-001 Porto, Portugal
- Unidade de Investigação e Formação-Centro Materno Infantil do Norte, 4099-001 Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, 4200-319, Portugal
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Aktoz F, Tercan C, Vurgun E, Aslancan R, Ürün H, Yücel B, Dursun S. What are the advantages of clock position method to determine fetal heart axis for inexperienced resident physicians? A comparative study. J Turk Ger Gynecol Assoc 2022; 23:95-98. [PMID: 35642358 PMCID: PMC9160999 DOI: 10.4274/jtgga.galenos.2022.2021-12-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective Residency training programs are challenging for young physicians with heavy workloads. Although ultrasonography (USG) is an imaging method that is frequently used in obstetrics practice, some basic USG skills can be acquired late in this intensive learning process. Likewise determining the fetal heart axis is an elementary evaluation but can turn into a challenging and time-consuming process, especially for inexperienced clinicians. Material and Methods Pregnant women between 20 and 37 weeks of gestation were recruited. Two observers assessed the axis of fetal heart by standard, Bronshtein and clock position methods. Fetal heart axis evaluation times were compared. Inter-observer and intra-observer agreements of the three methods were measured. One factor learning rates were calculated. Results A total of 31 pregnant patients between the ages of 18 and 40 years were included in the study. Fetal heart axis evaluation time by the clock position method was shorter than the Bronshtein and standard method in both observers. Furthermore diagnostic accuracy for both observers was 100% with the clock position method, while this fell to 100% in observer-1 and 96.8% in observer-2 using the Bronshtein method. The clock position method was learned faster than either of the other methods. Conclusion Clock position method is an easy and feasible method for inexperienced resident physicians in terms of learning and application to determine the fetal heart axis. The advantages of this method increase when patient numbers are higher.
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Affiliation(s)
- Fatih Aktoz
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Can Tercan
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Eren Vurgun
- Clinic of Medical Biochemistry, University of Health Sciences Turkey, Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Turkey
| | - Reyhan Aslancan
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Hanife Ürün
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Burak Yücel
- Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
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Zepeda‐Mendoza CJ, Essendrup A, Smoley SA, Johnson SH, Hoppman NL, Vasmatzis G, Jackson DL, Kearney HM, Baughn LB. Prenatal characterization of a novel inverted SMAD2 duplication by mate pair sequencing in a fetus with dextrocardia. Clin Case Rep 2021; 9:769-774. [PMID: 33598243 PMCID: PMC7869371 DOI: 10.1002/ccr3.3608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/01/2020] [Indexed: 11/06/2022] Open
Abstract
This case report underlines the importance of molecular characterization of genomic duplications and other structural variants in the prenatal setting to guide clinical interpretation, genetic counseling, and perinatal medical care.
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Affiliation(s)
| | - Anna Essendrup
- Division of Laboratory GeneticsDepartment of Laboratory Medicine and Pathology, Mayo ClinicRochesterMNUSA
| | - Stephanie A. Smoley
- Division of Laboratory GeneticsDepartment of Laboratory Medicine and Pathology, Mayo ClinicRochesterMNUSA
| | - Sarah H. Johnson
- Center for Individualized Medicine‐Biomarker Discovery, Mayo ClinicRochesterMNUSA
| | - Nicole L Hoppman
- Division of Laboratory GeneticsDepartment of Laboratory Medicine and Pathology, Mayo ClinicRochesterMNUSA
| | - George Vasmatzis
- Center for Individualized Medicine‐Biomarker Discovery, Mayo ClinicRochesterMNUSA
- Department of Molecular MedicineMayo ClinicRochesterMNUSA
| | - Daniel L. Jackson
- Department of Obstetrics, Gynecology and Women's HealthUniversity of Missouri HealthColumbiaMOUSA
| | - Hutton M. Kearney
- Division of Laboratory GeneticsDepartment of Laboratory Medicine and Pathology, Mayo ClinicRochesterMNUSA
| | - Linda B. Baughn
- Division of Laboratory GeneticsDepartment of Laboratory Medicine and Pathology, Mayo ClinicRochesterMNUSA
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Koenig ZA, Verhoeven A, Rosen D, Petrone AB. Lateral Heterotaxy Syndrome in a Newborn Caucasian Male. Cureus 2020; 12:e11205. [PMID: 33269136 PMCID: PMC7704025 DOI: 10.7759/cureus.11205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Heterotaxy syndrome is a varied spectrum of rearrangements of thoracic and abdominal organs that present many unique complications. Among all congenital deformities, heterotaxy syndrome is rare although this is likely an underestimate without routine imaging due to the benign nature of some defects. Numerous genes have been identified that play a role in its pathogenesis, and it has been hypothesized that heterotaxy syndrome is a consequence of both genetic and environmental impacts on the body axis. This case report also demonstrates the fundamental role of cardiac catheterization and imaging in further specifying the subtype of heterotaxy. Furthermore, it highlights the inconsistency of laterality with functional asplenia, visceral situs ambiguus, double-outlet right ventricle, and a left-sided inferior vena cava apart from other anomalies in a newborn male.
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Affiliation(s)
- Zachary A Koenig
- Medicine, West Virginia University School of Medicine, Morgantown, USA
| | - Alex Verhoeven
- Pediatrics, West Virginia University School of Medicine, Morgantown, USA
| | - David Rosen
- Anesthesiology, West Virginia University School of Medicine, Morgantown, USA
| | - Ashley B Petrone
- Pathology, Anatomy, Laboratory Medicine, West Virginia University School of Medicine, Morgantown, USA
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Gao X, Huang Z, Feng C, Guan C, Li R, Xie H, Chen J, Li M, Que R, Deng B, Cao P, Li M, Lu J, Huang Y, Li M, Yang W, Yang X, Wen C, Liang X, Yang Q, Chao YX, Chan LL, Yenari MA, Jin K, Chaudhuri KR, Zhang J, Tan EK, Wang Q. Multimodal analysis of gene expression from postmortem brains and blood identifies synaptic vesicle trafficking genes to be associated with Parkinson's disease. Brief Bioinform 2020; 22:5932213. [PMID: 33079984 DOI: 10.1093/bib/bbaa244] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/23/2020] [Accepted: 09/01/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE We aimed to identify key susceptibility gene targets in multiple datasets generated from postmortem brains and blood of Parkinson's disease (PD) patients and healthy controls (HC). METHODS We performed a multitiered analysis to integrate the gene expression data using multiple-gene chips from 244 human postmortem tissues. We identified hub node genes in the highly PD-related consensus module by constructing protein-protein interaction (PPI) networks. Next, we validated the top four interacting genes in 238 subjects (90 sporadic PD, 125 HC and 23 Parkinson's Plus Syndrome (PPS)). Utilizing multinomial logistic regression analysis (MLRA) and receiver operating characteristic (ROC), we analyzed the risk factors and diagnostic power for discriminating PD from HC and PPS. RESULTS We identified 1333 genes that were significantly different between PD and HCs based on seven microarray datasets. The identified MEturquoise module is related to synaptic vesicle trafficking (SVT) dysfunction in PD (P < 0.05), and PPI analysis revealed that SVT genes PPP2CA, SYNJ1, NSF and PPP3CB were the top four hub node genes in MEturquoise (P < 0.001). The levels of these four genes in PD postmortem brains were lower than those in HC brains. We found lower blood levels of PPP2CA, SYNJ1 and NSF in PD compared with HC, and lower SYNJ1 in PD compared with PPS (P < 0.05). SYNJ1, negatively correlated to PD severity, displayed an excellent power to discriminating PD from HC and PPS. CONCLUSIONS This study highlights that SVT genes, especially SYNJ1, may be promising markers in discriminating PD from HCs and PPS.
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Affiliation(s)
- Xiaoya Gao
- Department of Neurology, Zhujiang Hospital, Southern Medical University, China
| | - Zifeng Huang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Cailing Feng
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Chaohao Guan
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Ruidong Li
- Genetics, Genomics, and Bioinformatics Program, Department of Botany and Plant Sciences of University of California, USA
| | - Haiting Xie
- Department of Neurology of Zhujiang Hospital of Southern Medical University, China
| | - Jian Chen
- Department of Neurology of Zhujiang Hospital of Southern Medical University, China
| | - Mingchun Li
- Department of Neurology of Zhujiang Hospital of Southern Medical University, China
| | - Rongfang Que
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Bin Deng
- Department of Neurology of Zhujiang Hospital of Southern Medical University, China
| | - Peihua Cao
- Clinical Research Centre of Zhujiang Hospital of Southern Medical University, China
| | - Mengyan Li
- Department of Neurology of First Municipal Hospital of Guangzhou, China
| | - Jianjun Lu
- Laboratory for Neuromodulation of Guangdong Second Provincial General Hospital, China
| | - Yihong Huang
- Department of Neurology of Fifth Affiliated Hospital of Southern Medical University, China
| | - Minzi Li
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guanghzou, China
| | - Weihong Yang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Xiaohua Yang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Chunyan Wen
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Xiaomei Liang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, China
| | - Qin Yang
- Department of Neurology of Zhujiang Hospital of Southern Medical University, China
| | - Yin-Xia Chao
- Department of Neurology of National Neuroscience Institute, Singapore General Hospital, Duke-NUS Medical School
| | - Ling-Ling Chan
- Department of Neurology of National Neuroscience Institute, Singapore General Hospital, Duke-NUS Medical School
| | | | - Kunlin Jin
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - K Ray Chaudhuri
- International Parkinson Foundation Centre of Excellence at Kings College Hospital and research director at Kings College Hospital, and Kings College, Denmark Hill, London, SE5 9RS UK
| | - Jing Zhang
- Department of Pathology, University of Washington School of Medicine (USA)
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore General Hospital, and a professor in the Duke-NUS Medical School, Singapore
| | - Qing Wang
- Head of Department of Neurology, Zhujiang Hospital, Southern Medical University, China
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