CC BY 4.0 · Glob Med Genet 2022; 09(01): 029-033
DOI: 10.1055/s-0041-1736566
Original Article

Investigation of Genetic Alterations in Congenital Heart Diseases in Prenatal Period

1   Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
,
Engin Atli
1   Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
,
Sinem Yalcintepe
1   Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
,
Selma Demir
1   Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
,
Rasime Kalkan
2   Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
,
Cisem Akurut
1   Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
,
Yasemin Ozen
1   Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
,
Hakan Gurkan
1   Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
› Author Affiliations

Abstract

The prenatal diagnosis of congenital heart disease (CHD) is important because of mortality risk. The onset of CHD varies, and depending on the malformation type, the risk of aneuploidy is changed. To identify possible genetic alterations in CHD, G-banding, chromosomal microarray or if needed DNA mutation analysis and direct sequence analysis should be planned.

In present study, to identify genetic alterations, cell culture, karyotype analysis, and single nucleotide polymorphism, array analyses were conducted on a total 950 samples. Interventional prenatal genetic examination was performed on 23 (2, 4%, 23/950) fetal CHD cases. Chromosomal abnormalities were detected in 5 out of 23 cases (21, 7%). Detected chromosomal abnormalities were 10q23.2 deletion, trisomy 18, 8p22.3-p23.2 deletion, 8q21.3-q24.3 duplication, 11q24.2q24.5 (9 Mb) deletion, and 8p22p12 (16.8 Mb) deletion. Our study highlights the importance of genetic testing in CHD.



Publication History

Received: 03 August 2021

Accepted: 09 September 2021

Article published online:
09 November 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Heron M. Deaths: leading causes for 2014. Natl Vital Stat Rep 2016; 65 (05) 1-96
  • 2 Holland BJ, Myers JA, Woods Jr CR. Prenatal diagnosis of critical congenital heart disease reduces risk of death from cardiovascular compromise prior to planned neonatal cardiac surgery: a meta-analysis. Ultrasound Obstet Gynecol 2015; 45 (06) 631-638
  • 3 Donofrio MT, Moon-Grady AJ, Hornberger LK. et al; American Heart Association Adults With Congenital Heart Disease Joint Committee of the Council on Cardiovascular Disease in the Young and Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and Council on Cardiovascular and Stroke Nursing. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation 2014; 129 (21) 2183-2242
  • 4 Rasiah SV, Publicover M, Ewer AK, Khan KS, Kilby MD, Zamora J. A systematic review of the accuracy of first-trimester ultrasound examination for detecting major congenital heart disease. Ultrasound Obstet Gynecol 2006; 28 (01) 110-116
  • 5 Friedberg MK, Silverman NH, Moon-Grady AJ. et al. Prenatal detection of congenital heart disease. J Pediatr 2009; 155 (01) 26-31 , 31.e1
  • 6 Song MS, Hu A, Dyamenahalli U. et al. Extracardiac lesions and chromosomal abnormalities associated with major fetal heart defects: comparison of intrauterine, postnatal and postmortem diagnoses. Ultrasound Obstet Gynecol 2009; 33 (05) 552-559
  • 7 Copel JA, Cullen M, Green JJ, Mahoney MJ, Hobbins JC, Kleinman CS. The frequency of aneuploidy in prenatally diagnosed congenital heart disease: an indication for fetal karyotyping. Am J Obstet Gynecol 1988; 158 (02) 409-413
  • 8 Wimalasundera RC, Gardiner HM. Congenital heart disease and aneuploidy. Prenat Diagn 2004; 24 (13) 1116-1122
  • 9 Tuuli MG, Dicke JM, Stamilio DM. et al. Prevalence and likelihood ratios for aneuploidy in fetuses diagnosed prenatally with isolated congenital cardiac defects. Am J Obstet Gynecol 2009; 201 (04) 390.e1-390.e5
  • 10 Mone F, Walsh C, Mulcahy C. et al. Prenatal detection of structural cardiac defects and presence of associated anomalies: a retrospective observational study of 1262 fetal echocardiograms. Prenat Diagn 2015; 35 (06) 577-582
  • 11 Moore JW, Binder GA, Berry R. Prenatal diagnosis of aneuploidy and deletion 22q11.2 in fetuses with ultrasound detection of cardiac defects. Am J Obstet Gynecol 2004; 191 (06) 2068-2073
  • 12 Ferencz C, Neill CA, Boughman JA, Rubin JD, Brenner JI, Perry LW. Congenital cardiovascular malformations associated with chromosome abnormalities: an epidemiologic study. J Pediatr 1989; 114 (01) 79-86
  • 13 Russell MW, Chung WK, Kaltman JR, Miller TA. Advances in the understanding of the genetic determinants of congenital heart disease and their impact on clinical outcomes. J Am Heart Assoc 2018; 7 (06) e006906
  • 14 Jansen FA, Blumenfeld YJ, Fisher A. et al. Array comparative genomic hybridization and fetal congenital heart defects: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 2015; 45 (01) 27-35
  • 15 Pierpont ME, Brueckner M, Chung WK. et al; American Heart Association Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; and Council on Genomic and Precision Medicine. Genetic basis for congenital heart disease: revisited: a scientific statement from the American Heart Association. Circulation 2018; 138 (21) e653-e711
  • 16 Hopkins MK, Dugoff L, Kuller JA. Congenital heart disease: prenatal diagnosis and genetic associations. Obstet Gynecol Surv 2019; 74 (08) 497-503
  • 17 International Society of Ultrasound in Obstetrics #38. Cardiac screening examination of the fetus: guidelines for performing the “basic” and “extended basic” cardiac scan. Ultrasound Obstet Gynecol 2006; 27 (01) 107-113
  • 18 Lee W, Allan L, Carvalho JS. et al; ISUOG Fetal Echocardiography Task Force. ISUOG consensus statement: what constitutes a fetal echocardiogram?. Ultrasound Obstet Gynecol 2008; 32 (02) 239-242
  • 19 Hunter S, Heads A, Wyllie J, Robson S. Prenatal diagnosis of congenital heart disease in the northern region of England: benefits of a training programme for obstetric ultrasonographers. Heart 2000; 84 (03) 294-298
  • 20 Wren C, Richmond S, Donaldson L. Temporal variability in birth prevalence of cardiovascular malformations. Heart 2000; 83 (04) 414-419
  • 21 van Velzen CL, Clur SA, Rijlaarsdam ME. et al. Prenatal diagnosis of congenital heart defects: accuracy and discrepancies in a multicenter cohort. Ultrasound Obstet Gynecol 2016; 47 (05) 616-622
  • 22 Yu Z, Xi Y, Ding W. et al. Congenital heart disease in a Chinese hospital: pre- and postnatal detection, incidence, clinical characteristics and outcomes. Pediatr Int 2011; 53 (06) 1059-1065
  • 23 Ozbarlas N, Erdem S, Küçükosmanoğlu O. et al. Prevalence and distribution of structural heart diseases in high and low risk pregnancies. Anadolu Kardiyol Derg 2011; 11 (02) 125-130
  • 24 Lee JE, Jung KL, Kim SE. et al. Prenatal diagnosis of congenital heart disease: trends in pregnancy termination rate, and perinatal and 1-year infant mortalities in Korea between 1994 and 2005. J Obstet Gynaecol Res 2010; 36 (03) 474-478
  • 25 Clur SA, Van Brussel PM, Mathijssen IB, Pajkrt E, Ottenkamp J, Bilardo CM. Audit of 10 years of referrals for fetal echocardiography. Prenat Diagn 2011; 31 (12) 1134-1140
  • 26 Dolk H, Loane M, Garne E. European Surveillance of Congenital Anomalies (EUROCAT) Working Group. Congenital heart defects in Europe: prevalence and perinatal mortality, 2000 to 2005. Circulation 2011; 123 (08) 841-849
  • 27 Breckpot J, Tranchevent LC, Thienpont B. et al. BMPR1A is a candidate gene for congenital heart defects associated with the recurrent 10q22q23 deletion syndrome. Eur J Med Genet 2012; 55 (01) 12-16
  • 28 Gaussin V, Van de Putte T, Mishina Y. et al. Endocardial cushion and myocardial defects after cardiac myocyte-specific conditional deletion of the bone morphogenetic protein receptor ALK3. Proc Natl Acad Sci U S A 2002; 99 (05) 2878-2883
  • 29 Gaussin V, Morley GE, Cox L. et al. Alk3/Bmpr1a receptor is required for development of the atrioventricular canal into valves and annulus fibrosus. Circ Res 2005; 97 (03) 219-226
  • 30 8p23 deletion syndrome, Unique 2013. Rare Chromosome Disorder Support Group, Version 2,1 (SW) 2013
  • 31 Wat MJ, Shchelochkov OA, Holder AM. et al. Chromosome 8p23.1 deletions as a cause of complex congenital heart defects and diaphragmatic hernia. Am J Med Genet A 2009; 149A (08) 1661-1677
  • 32 Digilio MC, Angioni A, Giannotti A, Dallapiccola B, Marino B. Truncus arteriosus and duplication 8q. Am J Med Genet A 2003; 121A (01) 79-81
  • 33 Sujansky E, Smith ACM, Prescott KE, Freehauf CL, Clericuzio C, Robinson A. Natural history of the recombinant (8) syndrome. Am J Med Genet 1993; 47 (04) 512-525
  • 34 So J, Stockley T, Stavropoulos DJ. Periventricular nodular heterotopia and transverse limb reduction defect in a woman with interstitial 11q24 deletion in the Jacobsen syndrome region. Am J Med Genet A 2014; 164A (02) 511-515
  • 35 Guerin A, Stavropoulos DJ, Diab Y. et al. Interstitial deletion of 11q-implicating the KIRREL3 gene in the neurocognitive delay associated with Jacobsen syndrome. Am J Med Genet A 2012; 158A (10) 2551-2556
  • 36 Tyson C, Qiao Y, Harvard C. et al. Submicroscopic deletions of 11q24-25 in individuals without Jacobsen syndrome: re-examination of the critical region by high-resolution array-CGH. Mol Cytogenet 2008; 1: 23
  • 37 Coldren CD, Lai Z, Shragg P. et al. Chromosomal microarray mapping suggests a role for BSX and Neurogranin in neurocognitive and behavioral defects in the 11q terminal deletion disorder (Jacobsen syndrome). Neurogenetics 2009; 10 (02) 89-95
  • 38 Maruani A, Huguet G, Beggiato A. et al. 11q24.2-25 micro-rearrangements in autism spectrum disorders: relation to brain structures. Am J Med Genet A 2015; 167A (12) 3019-3030
  • 39 Grossfeld PD, Mattina T, Lai Z. et al. The 11q terminal deletion disorder: a prospective study of 110 cases. Am J Med Genet A 2004; 129A (01) 51-61
  • 40 Zhan Y, Brown C, Maynard E. et al. Ets-1 is a critical regulator of Ang II-mediated vascular inflammation and remodeling. J Clin Invest 2005; 115 (09) 2508-2516
  • 41 Davidson B, Shi W, Beh J, Christiaen L, Levine M. FGF signaling delineates the cardiac progenitor field in the simple chordate, Ciona intestinalis. Genes Dev 2006; 20 (19) 2728-2738
  • 42 Alvarez AD, Shi W, Wilson BA, Skeath JB. pannier and pointedP2 act sequentially to regulate Drosophila heart development. Development 2003; 130 (13) 3015-3026
  • 43 Ye M, Coldren C, Liang X. et al. Deletion of ETS-1, a gene in the Jacobsen syndrome critical region, causes ventricular septal defects and abnormal ventricular morphology in mice. Hum Mol Genet 2010; 19 (04) 648-656
  • 44 Gao Z, Kim GH, Mackinnon AC. et al. Ets1 is required for proper migration and differentiation of the cardiac neural crest. Development 2010; 137 (09) 1543-1551