Amy R Shikany1, Benjamin J Landis2, Ashley Parrott3, Erin M Miller4, Alyxis Coyan5, Lauren Walters6, Robert B Hinton4, Paula Goldenberg7, Stephanie M Ware2. 1. The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: Amy.shikany@cchmc.org. 2. Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN. 3. Genome Medical, San Francisco, CA. 4. The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 5. Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 6. Invitae Genetics, San Francisco, CA. 7. Massachusetts General Hospital, Medical Genetics, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
Abstract
OBJECTIVE: To investigate the frequency of genetic diagnoses among infants with critical congenital heart disease (CHD) using a comprehensive cardiovascular genetics approach and to identify genotype-phenotype correlations. STUDY DESIGN: A retrospective chart review of patients evaluated by cardiovascular genetics in a pediatric cardiac intensive care unit from 2010 to 2015 was performed. Infants with CHD who were <1 month of age were included. CHD was classified using structured phenotype definitions. Cardiac and noncardiac phenotypes were tested for associations with abnormal genetic testing using χ1 and Fisher exact tests. RESULTS: Genetic evaluation was completed in 293 infants with CHD, of whom 213 had isolated congenital heart disease (iCHD) and 80 had multiple congenital anomalies. Overall, the yield of abnormal genetic testing was 26%. The multiple congenital anomalies cohort had a greater yield of genetic testing (39%) than the iCHD cohort (20%) (OR 2.7). Using a non-hierarchical CHD classification and excluding 22q11.2 deletion and common aneuploidies, right ventricular obstructive defects were associated with abnormal genetic testing (P = .0005). Extracardiac features associated with abnormal genetic testing included ear, nose, and throat (P = .003) and brain (P = .0001) abnormalities. A diagnosis of small for gestational age or intrauterine growth retardation also was associated with abnormal genetic testing (P = .0061), as was presence of dysmorphic features (P = .0033, OR 3.5). Infants without dysmorphia with iCHD or multiple congenital anomalies had similar frequencies of abnormal genetic testing. CONCLUSIONS: The present study provides evidence to support a comprehensive cardiovascular genetics approach in evaluating infants with critical CHD while also identifying important genotype-phenotype considerations.
OBJECTIVE: To investigate the frequency of genetic diagnoses among infants with critical congenital heart disease (CHD) using a comprehensive cardiovascular genetics approach and to identify genotype-phenotype correlations. STUDY DESIGN: A retrospective chart review of patients evaluated by cardiovascular genetics in a pediatric cardiac intensive care unit from 2010 to 2015 was performed. Infants with CHD who were <1 month of age were included. CHD was classified using structured phenotype definitions. Cardiac and noncardiac phenotypes were tested for associations with abnormal genetic testing using χ1 and Fisher exact tests. RESULTS: Genetic evaluation was completed in 293 infants with CHD, of whom 213 had isolated congenital heart disease (iCHD) and 80 had multiple congenital anomalies. Overall, the yield of abnormal genetic testing was 26%. The multiple congenital anomalies cohort had a greater yield of genetic testing (39%) than the iCHD cohort (20%) (OR 2.7). Using a non-hierarchical CHD classification and excluding 22q11.2 deletion and common aneuploidies, right ventricular obstructive defects were associated with abnormal genetic testing (P = .0005). Extracardiac features associated with abnormal genetic testing included ear, nose, and throat (P = .003) and brain (P = .0001) abnormalities. A diagnosis of small for gestational age or intrauterine growth retardation also was associated with abnormal genetic testing (P = .0061), as was presence of dysmorphic features (P = .0033, OR 3.5). Infants without dysmorphia with iCHD or multiple congenital anomalies had similar frequencies of abnormal genetic testing. CONCLUSIONS: The present study provides evidence to support a comprehensive cardiovascular genetics approach in evaluating infants with critical CHD while also identifying important genotype-phenotype considerations.
Authors: Andrew P Landstrom; Jeffrey J Kim; Bruce D Gelb; Benjamin M Helm; Prince J Kannankeril; Christopher Semsarian; Amy C Sturm; Martin Tristani-Firouzi; Stephanie M Ware Journal: Circ Genom Precis Med Date: 2021-08-20
Authors: K Nicole Weaver; Jing Chen; Amy Shikany; Pete S White; Carlos E Prada; Bruce D Gelb; James F Cnota Journal: Circ Genom Precis Med Date: 2022-06-06
Authors: Ami B Bhatt; Maria R Lantin-Hermoso; Curt J Daniels; Robert Jaquiss; Benjamin John Landis; Bradley S Marino; Rahul H Rathod; Robert N Vincent; Bradley B Keller; Juan Villafane Journal: Front Cardiovasc Med Date: 2022-05-25