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DOI QR Code

Genetic Syndromes associated with Congenital Heart Disease

  • Ko, Jung Min (Department of Pediatrics, Seoul National University College of Medicine)
  • Received : 2015.03.24
  • Accepted : 2015.04.21
  • Published : 2015.09.30

Abstract

Recent research has demonstrated that genetic alterations or variations contribute considerably to the development of congenital heart disease. Many kinds of genetic tests are commercially available, and more are currently under development. Congenital heart disease is frequently accompanied by genetic syndromes showing both cardiac and extra-cardiac anomalies. Congenital heart disease is the leading cause of birth defects, and is an important cause of morbidity and mortality during infancy and childhood. This review introduces common genetic syndromes showing various types of congenital heart disease, including Down syndrome, Turner syndrome, 22q11 deletion syndrome, Williams syndrome, and Noonan syndrome. Although surgical techniques and perioperative care have improved substantially, patients with genetic syndromes may be at an increased risk of death or major complications associated with surgery. Therefore, risk management based on an accurate genetic diagnosis is necessary in order to effectively plan the surgical and medical management and follow-up for these patients. In addition, multidisciplinary approaches and care for the combined extra-cardiac anomalies may help to reduce mortality and morbidity accompanied with congenital heart disease.

Keywords

References

  1. Eskedal LT, Hagemo PS, Eskild A, Froslie KF, Seiler S, Thaulow E. A population-based study relevant to seasonal variations in causes of death in children undergoing surgery for congenital cardiac malformations. Cardiol Young 2007;17:423-31. https://doi.org/10.1017/S1047951107000881
  2. Bray I, Wright DE, Davies C, Hook EB. Joint estimation of Down syndrome risk and ascertainment rates: a meta-analysis of nine published data sets. Prenat Diagn 1998;18:9-20. https://doi.org/10.1002/(SICI)1097-0223(199801)18:1<9::AID-PD210>3.0.CO;2-F
  3. Cleves MA, Hobbs CA, Cleves PA, Tilford JM, Bird TM, Robbins JM. Congenital defects among liveborn infants with Down syndrome. Birth Defects Res A Clin Mol Teratol 2007;79:657-63. https://doi.org/10.1002/bdra.20393
  4. Bull MJ; Committee on Genetics. Health supervision for children with Down syndrome. Pediatrics 2011;128:393-406. https://doi.org/10.1542/peds.2011-1605
  5. Marino B. Left-sided cardiac obstruction in patients with Down syndrome. J Pediatr 1989;115:834-5.
  6. Carmi R, Boughman JA, Ferencz C. Endocardial cushion defect: further studies of "isolated" versus "syndromic" occurrence. Am J Med Genet 1992;43:569-75. https://doi.org/10.1002/ajmg.1320430313
  7. Tubman TR, Shields MD, Craig BG, Mulholland HC, Nevin NC. Congenital heart disease in Down’s syndrome: two year prospective early screening study. BMJ 1991;302:1425-7. https://doi.org/10.1136/bmj.302.6790.1425
  8. Tucker EM, Pyles LA, Bass JL, Moller JH. Permanent pacemaker for atrioventricular conduction block after operative repair of perimembranous ventricular septal defect. J Am Coll Cardiol 2007;50:1196-200. https://doi.org/10.1016/j.jacc.2007.06.014
  9. Stochholm K, Juul S, Juel K, Naeraa RW, Gravholt CH. Prevalence, incidence, diagnostic delay, and mortality in Turner syndrome. J Clin Endocrinol Metab 2006;91:3897-902. https://doi.org/10.1210/jc.2006-0558
  10. Prandstraller D, Mazzanti L, Picchio FM, et al. Turner’s syndrome: cardiologic profile according to the different chromosomal patterns and long-term clinical follow-up of 136 nonpreselected patients. Pediatr Cardiol 1999;20:108-12. https://doi.org/10.1007/s002469900416
  11. Davenport ML. Approach to the patient with Turner syndrome. J Clin Endocrinol Metab 2010;95:1487-95. https://doi.org/10.1210/jc.2009-0926
  12. Bondy CA; Turner Syndrome Study Group. Care of girls and women with Turner syndrome: a guideline of the Turner Syndrome Study Group. J Clin Endocrinol Metab 2007;92:10-25. https://doi.org/10.1210/jc.2006-1374
  13. Dulac Y, Pienkowski C, Abadir S, Tauber M, Acar P. Cardiovascular abnormalities in Turner's syndrome: what prevention? Arch Cardiovasc Dis 2008;101:485-90. https://doi.org/10.1016/j.acvd.2008.05.007
  14. Botto LD, May K, Fernhoff PM, et al. A population-based study of the 22q11.2 deletion: phenotype, incidence, and contribution to major birth defects in the population. Pediatrics 2003;112:101-7. https://doi.org/10.1542/peds.112.1.101
  15. McDonald-McGinn DM, Emanuel BS, Zackai EH. 22q11.2 Deletion syndrome. In: Pagon RA, Adam MP, Ardinger HH, et al, editors. GeneReviews (R). University of Washington: Seattle (WA), 1993.
  16. Baldini A. Dissecting contiguous gene defects: TBX1. Curr Opin Genet Dev 2005;15:279-84. https://doi.org/10.1016/j.gde.2005.03.001
  17. Scambler PJ. The 22q11 deletion syndromes. Hum Mol Genet 2000;9:2421-6. https://doi.org/10.1093/hmg/9.16.2421
  18. Gerdes M, Solot C, Wang PP, et al. Cognitive and behavior profile of preschool children with chromosome 22q11.2 deletion. Am J Med Genet 1999;85:127-33. https://doi.org/10.1002/(SICI)1096-8628(19990716)85:2<127::AID-AJMG6>3.0.CO;2-F
  19. Moss EM, Batshaw ML, Solot CB, et al. Psychoeducational profile of the 22q11.2 microdeletion: a complex pattern. J Pediatr 1999;134:193-8. https://doi.org/10.1016/S0022-3476(99)70415-4
  20. Oskarsdóttir S, Belfrage M, Sandstedt E, Viggedal G, Uvebrant P. Disabilities and cognition in children and adolescents with 22q11 deletion syndrome. Dev Med Child Neurol 2005;47:177-84. https://doi.org/10.1017/S0012162205000320
  21. Pierpont ME, Basson CT, Benson DW Jr, et al. Genetic basis for congenital heart defects: current knowledge: a scientific statement from the American Heart Association Congenital Cardiac Defects Committee, Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation 2007;115:3015-38. https://doi.org/10.1161/CIRCULATIONAHA.106.183056
  22. Bassett AS, McDonald-McGinn DM, Devriendt K, et al. Practical guidelines for managing patients with 22q11.2 deletion syndrome. J Pediatr 2011;159:332-9.e1. https://doi.org/10.1016/j.jpeds.2011.02.039
  23. Committee on Genetics. American Academy of Pediatrics: health care supervision for children with Williams syndrome. Pediatrics 2001;107:1192-204.
  24. Stromme P, Bjornstad PG, Ramstad K. Prevalence estimation of Williams syndrome. J Child Neurol 2002;17:269-71. https://doi.org/10.1177/088307380201700406
  25. Adams GN, Schmaier AH. The Williams-Beuren Syndrome-a window into genetic variants leading to the development of cardiovascular disease. PLoS Genet 2012;8:e1002479. https://doi.org/10.1371/journal.pgen.1002479
  26. Li DY, Toland AE, Boak BB, et al. Elastin point mutations cause an obstructive vascular disease, supravalvular aortic stenosis. Hum Mol Genet 1997;6:1021-8. https://doi.org/10.1093/hmg/6.7.1021
  27. Pober BR. Williams-Beuren syndrome. N Engl J Med 2010;362:239-52. https://doi.org/10.1056/NEJMra0903074
  28. Kececioglu D, Kotthoff S, Vogt J. Williams-Beuren syndrome: a 30-year follow-up of natural and postoperative course. Eur Heart J 1993;14:1458-64. https://doi.org/10.1093/eurheartj/14.11.1458
  29. Zalzstein E, Moes CA, Musewe NN, Freedom RM. Spectrum of cardiovascular anomalies in Williams-Beuren syndrome. Pediatr Cardiol 1991;12:219-23. https://doi.org/10.1007/BF02310569
  30. Collins RT 2nd. Cardiovascular disease in Williams syndrome. Circulation 2013;127:2125-34. https://doi.org/10.1161/CIRCULATIONAHA.112.000064
  31. Collins RT 2nd, Kaplan P, Somes GW, Rome JJ. Long-term outcomes of patients with cardiovascular abnormalities and Williams syndrome. Am J Cardiol 2010;105:874-8. https://doi.org/10.1016/j.amjcard.2009.10.069
  32. van der Burgt I. Noonan syndrome. Orphanet J Rare Dis 2007;2:4. https://doi.org/10.1186/1750-1172-2-4
  33. Roberts AE, Allanson JE, Tartaglia M, Gelb BD. Noonan syndrome. Lancet 2013;381:333-42. https://doi.org/10.1016/S0140-6736(12)61023-X
  34. Ko JM, Kim JM, Kim GH, Yoo HW. PTPN11, SOS1, KRAS, and RAF1 gene analysis, and genotype-phenotype correlation in Korean patients with Noonan syndrome. J Hum Genet 2008;53:999-1006. https://doi.org/10.1007/s10038-008-0343-6
  35. Lee BH, Kim JM, Jin HY, Kim GH, Choi JH, Yoo HW. Spectrum of mutations in Noonan syndrome and their correlation with phenotypes. J Pediatr 2011;159:1029-35. https://doi.org/10.1016/j.jpeds.2011.05.024
  36. Aoki Y, Niihori T, Narumi Y, Kure S, Matsubara Y. The RAS/MAPK syndromes:novel roles of the RAS pathway in human genetic disorders. Hum Mutat 2008;29:992-1006. https://doi.org/10.1002/humu.20748
  37. Marino B, Digilio MC, Toscano A, Giannotti A, Dallapiccola B. Congenital heart diseases in children with Noonan syndrome: an expanded cardiac spectrum with high prevalence of atrioventricular canal. J Pediatr 1999;135:703-6. https://doi.org/10.1016/S0022-3476(99)70088-0
  38. Formigari R, Michielon G, Digilio MC, et al. Genetic syndromes and congenital heart defects: how is surgical management affected? Eur J Cardiothorac Surg 2009;35:606-14. https://doi.org/10.1016/j.ejcts.2008.11.005
  39. Shaw AC, Kalidas K, Crosby AH, Jeffery S, Patton MA. The natural history of Noonan syndrome: a long-term follow-up study. Arch Dis Child 2007;92:128-32.
  40. Fahed AC, Gelb BD, Seidman JG, Seidman CE. Genetics of congenital heart disease: the glass half empty. Circ Res 2013;112:707-20. https://doi.org/10.1161/CIRCRESAHA.112.300853

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