Hanchard Neil A, Umana Luis A, D'Alessandro Lisa, Azamian Mahshid, Poopola Mojisola, Morris Shaine A, Fernbach Susan, Lalani Seema R, Towbin Jeffrey A, Zender Gloria A, Fitzgerald-Butt Sara, Garg Vidu, Bowman Jessica, Zapata Gladys, Hernandez Patricia, Arrington Cammon B, Furthner Dieter, Prakash Siddharth K, Bowles Neil E, McBride Kim L, Belmont John W
Department of Human and Molecular Genetics, Baylor College of Medicine, Houston, Texas.
USDA/ARS/Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas.
Am J Med Genet A. 2017 Aug;173(8):2176-2188. doi: 10.1002/ajmg.a.38309. Epub 2017 Jun 27.
Congenital left-sided cardiac lesions (LSLs) are a significant contributor to the mortality and morbidity of congenital heart disease (CHD). Structural copy number variants (CNVs) have been implicated in LSL without extra-cardiac features; however, non-penetrance and variable expressivity have created uncertainty over the use of CNV analyses in such patients. High-density SNP microarray genotyping data were used to infer large, likely-pathogenic, autosomal CNVs in a cohort of 1,139 probands with LSL and their families. CNVs were molecularly confirmed and the medical records of individual carriers reviewed. The gene content of novel CNVs was then compared with public CNV data from CHD patients. Large CNVs (>1 MB) were observed in 33 probands (∼3%). Six of these were de novo and 14 were not observed in the only available parent sample. Associated cardiac phenotypes spanned a broad spectrum without clear predilection. Candidate CNVs were largely non-recurrent, associated with heterozygous loss of copy number, and overlapped known CHD genomic regions. Novel CNV regions were enriched for cardiac development genes, including seven that have not been previously associated with human CHD. CNV analysis can be a clinically useful and molecularly informative tool in LSLs without obvious extra-cardiac defects, and may identify a clinically relevant genomic disorder in a small but important proportion of these individuals.
先天性左侧心脏病变(LSLs)是先天性心脏病(CHD)死亡率和发病率的重要影响因素。结构拷贝数变异(CNVs)已被证实与无心脏外特征的LSLs有关;然而,非外显率和可变表达性使得在这类患者中使用CNV分析存在不确定性。利用高密度单核苷酸多态性(SNP)微阵列基因分型数据,推断1139例LSLs先证者及其家族中的大的、可能致病的常染色体CNVs。对CNVs进行分子确认,并查阅个体携带者的病历。然后将新发现的CNVs的基因内容与CHD患者的公共CNV数据进行比较。在33例先证者(约3%)中观察到大型CNVs(>1 MB)。其中6例为新发突变,14例在仅有的可用亲本样本中未观察到。相关的心脏表型范围广泛,无明显偏好。候选CNVs大多为非复发性,与拷贝数杂合性缺失相关,并与已知的CHD基因组区域重叠。新的CNV区域富含心脏发育基因,其中7个基因以前未与人类CHD相关联。在无明显心脏外缺陷的LSLs中,CNV分析可能是一种临床有用且具有分子信息的工具,并且可能在一小部分但很重要的个体中识别出临床相关的基因组疾病。