Marino B, Digilio M C
Pediatric Cardiology and Genetics, Bambino Gesù Hospital, Rome, Italy.
Cardiovasc Pathol. 2000 Nov-Dec;9(6):303-15. doi: 10.1016/s1054-8807(00)00050-8.
The increasing role of genetic factors in the etiology of congenital heart defects is shown by the high frequency of genetic syndromes and extracardiac malformations in these patients. The accurate study of cardiac anatomy disclosed that peculiar morphologic subtypes of heart defects are related to specific genetic conditions. The correlation between anatomic cardiac patterns and some genetic anomalies (trisomy, deletion, mutation) suggests that specific morphogenetic mechanisms put in motion by gene(s) can result in a specific cardiac phenotype. In this review we analyze the cardiac morphology and the frequent genetic syndromes in five groups of congenital heart diseases: right-sided obstructions, left-sided obstructions, atrioventricular canal defects, ventricular septal defects, and conotruncal defects. Progress in this field is due not only to new research in molecular biology, but also to the attention of clinicians to a detailed cardiac diagnosis and to specific correlations between genotype and phenotype.
遗传因素在先天性心脏病病因学中作用的日益增加,体现在这些患者中遗传综合征和心外畸形的高发生率上。对心脏解剖结构的精确研究表明,心脏缺陷的特殊形态学亚型与特定的遗传状况相关。心脏解剖模式与一些遗传异常(三体、缺失、突变)之间的相关性表明,由基因启动的特定形态发生机制可导致特定的心脏表型。在本综述中,我们分析了五组先天性心脏病的心脏形态和常见遗传综合征:右侧梗阻、左侧梗阻、房室管缺损、室间隔缺损和圆锥干缺损。该领域的进展不仅归功于分子生物学的新研究,还归功于临床医生对详细心脏诊断以及基因型与表型之间特定相关性的关注。