Circulation. 2018 Nov 20;138(21):e653-e711. doi: 10.1161/CIR.0000000000000606.
This review provides an updated summary of the state of our knowledge of the genetic contributions to the pathogenesis of congenital heart disease. Since 2007, when the initial American Heart Association scientific statement on the genetic basis of congenital heart disease was published, new genomic techniques have become widely available that have dramatically changed our understanding of the causes of congenital heart disease and, clinically, have allowed more accurate definition of the pathogeneses of congenital heart disease in patients of all ages and even prenatally. Information is presented on new molecular testing techniques and their application to congenital heart disease, both isolated and associated with other congenital anomalies or syndromes. Recent advances in the understanding of copy number variants, syndromes, RASopathies, and heterotaxy/ciliopathies are provided. Insights into new research with congenital heart disease models, including genetically manipulated animals such as mice, chicks, and zebrafish, as well as human induced pluripotent stem cell-based approaches are provided to allow an understanding of how future research breakthroughs for congenital heart disease are likely to happen. It is anticipated that this review will provide a large range of health care-related personnel, including pediatric cardiologists, pediatricians, adult cardiologists, thoracic surgeons, obstetricians, geneticists, genetic counselors, and other related clinicians, timely information on the genetic aspects of congenital heart disease. The objective is to provide a comprehensive basis for interdisciplinary care for those with congenital heart disease.
这篇综述提供了对先天性心脏病发病机制的遗传贡献的最新知识总结。自 2007 年首次发表美国心脏协会关于先天性心脏病遗传基础的科学声明以来,新的基因组技术已经广泛应用,极大地改变了我们对先天性心脏病病因的认识,并且在临床上,能够更准确地定义各个年龄段甚至产前患者的先天性心脏病的发病机制。本文介绍了新的分子检测技术及其在孤立性和伴发其他先天性畸形或综合征的先天性心脏病中的应用。还提供了关于拷贝数变异、综合征、RAS 相关疾病和异构/纤毛疾病的最新研究进展。提供了对先天性心脏病模型(包括基因改造的动物,如老鼠、小鸡和斑马鱼)以及基于人类诱导多能干细胞的方法的新研究的见解,以了解未来的研究突破可能如何发生。预计本综述将为包括儿科心脏病专家、儿科医生、成人心脏病专家、胸外科医生、妇产科医生、遗传学家、遗传咨询师和其他相关临床医生在内的广大医疗保健相关人员提供有关先天性心脏病遗传方面的及时信息。其目的是为患有先天性心脏病的患者提供跨学科护理的综合基础。