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Wang T, Chen L, Yang T, Huang P, Wang L, Zhao L, Zhang S, Ye Z, Chen L, Zheng Z, Qin J. Congenital Heart Disease and Risk of Cardiovascular Disease: A Meta-Analysis of Cohort Studies. J Am Heart Assoc 2020; 8:e012030. [PMID: 31070503 PMCID: PMC6585327 DOI: 10.1161/jaha.119.012030] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Despite remarkable success in the surgical and medical management of congenital heart disease ( CHD ), some survivors still experience cardiovascular complications over the long term. The goal of this study was to evaluate the association between CHD and risk of cardiovascular disease ( CVD ) by conducting a meta-analysis of cohort studies. Methods and Results A systematic literature search of several databases was conducted through April 2018 to identify studies reporting the risk of CVD , stroke, heart failure, and coronary artery heart disease in CHD survivors. The quality of individual studies was assessed using the Newcastle-Ottawa scale. The overall risk estimates were pooled using fixed-effects meta-analysis. Subgroup analyses were performed to explore possible sources of heterogeneity. Nine cohort studies comprising 684 200 participants were included. The overall combined relative risks for people with CHD compared with the controls were 3.12 (95% CI, 3.01-3.24) for CVD , 2.46 (95% CI, 2.30-2.63) for stroke, 5.89 (95% CI, 5.58-6.21) for heart failure, and 1.50 (95% CI, 1.40-1.61) for coronary artery heart disease. Significant heterogeneity was detected across studies regarding these risk estimates. Heterogeneity in the risk estimate of CVD was explained by geographic region, type of study design, sample source, age composition, and controlled confounders. Conclusions This meta-analysis of cohort studies of CHD found an association of increased risk of CVD in later life, although we cannot determine whether this association is confounded by a risk factor profile of CVD among CHD survivors or whether CHD is an independent risk factor.
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Affiliation(s)
- Tingting Wang
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Lizhang Chen
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Tubao Yang
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Peng Huang
- 2 Department of Cardio-Thoracic Surgery Hunan Children's Hospital Changsha China
| | - Lesan Wang
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Lijuan Zhao
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Senmao Zhang
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Ziwei Ye
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Letao Chen
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Zan Zheng
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
| | - Jiabi Qin
- 1 Department of Epidemiology and Health Statistics Xiangya School of Public Health Central South University Changsha China
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Hinton RB, Ware SM. Heart Failure in Pediatric Patients With Congenital Heart Disease. Circ Res 2017; 120:978-994. [PMID: 28302743 DOI: 10.1161/circresaha.116.308996] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/27/2016] [Accepted: 12/28/2016] [Indexed: 12/14/2022]
Abstract
Heart failure (HF) is a complex clinical syndrome resulting from diverse primary and secondary causes and shared pathways of disease progression, correlating with substantial mortality, morbidity, and cost. HF in children is most commonly attributable to coexistent congenital heart disease, with different risks depending on the specific type of malformation. Current management and therapy for HF in children are extrapolated from treatment approaches in adults. This review discusses the causes, epidemiology, and manifestations of HF in children with congenital heart disease and presents the clinical, genetic, and molecular characteristics that are similar or distinct from adult HF. The objective of this review is to provide a framework for understanding rapidly increasing genetic and molecular information in the challenging context of detailed phenotyping. We review clinical and translational research studies of HF in congenital heart disease including at the genome, transcriptome, and epigenetic levels. Unresolved issues and directions for future study are presented.
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Affiliation(s)
- Robert B Hinton
- From the Department of Pediatrics and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis
| | - Stephanie M Ware
- From the Department of Pediatrics and Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis.
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Abstract
Congenital heart disease (CHD) is the most common class of major malformations in humans. The historical association with large chromosomal abnormalities foreshadowed the role of submicroscopic rare copy number variations (CNVs) as important genetic causes of CHD. Recent studies have provided robust evidence for these structural variants as genome-wide contributors to all forms of CHD, including CHD that appears isolated without extra-cardiac features. Overall, a CNV-related molecular diagnosis can be made in up to one in eight patients with CHD. These include de novo and inherited variants at established (chromosome 22q11.2), emerging (chromosome 1q21.1), and novel loci across the genome. Variable expression of rare CNVs provides support for the notion of a genetic spectrum of CHD that crosses traditional anatomic classification boundaries. Clinical genetic testing using genome-wide technologies (e.g., chromosomal microarray analysis) is increasingly employed in prenatal, paediatric and adult settings. CNV discoveries in CHD have translated to changes to clinical management, prognostication and genetic counselling. The convergence of findings at individual gene and at pathway levels is shedding light on the mechanisms that govern human cardiac morphogenesis. These clinical and research advances are helping to inform whole-genome sequencing, the next logical step in delineating the genetic architecture of CHD.
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de Denus S, Andelfinger G, Khairy P. Personalizing the management of heart failure in congenital heart disease: challenges and opportunities. Pharmacogenomics 2014; 15:123-7. [DOI: 10.2217/pgs.13.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Simon de Denus
- Faculty of Pharmacy, Université de Montréal, Montreal, Canada and Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec H1T 1C8, Canada
| | - Gregor Andelfinger
- Faculty of Medicine, Université de Montréal, Montreal, Canada and Sainte-Justine Hospital, Montreal, QC, Canada
| | - Paul Khairy
- Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec H1T 1C8, Canada and Faculty of Medicine, Université de Montréal, Montreal, Canada
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Abstract
With the increasing use of next-generation sequencing applications, there has been an increase in identification of genetic causes of cardiac disease. This technology has also enabled the transition of these genes into the clinical setting and the rapid growth of large gene tests for the diagnosis of heart disorders. The ability to combine tests to include similar, but distinct, diseases has shown that many genes can be responsible for a wide variety of both syndromic and nonsyndromic disorders. This article discusses the current state of molecular genetic diagnosis for cardiac disorders, focusing on diseases with mendelian inheritance.
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Affiliation(s)
- Matthew S Lebo
- Partners HealthCare Center for Personalized Genetic Medicine, Boston, MA, USA; Department of Pathology, Brigham and Woman's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
| | - Samantha M Baxter
- Partners HealthCare Center for Personalized Genetic Medicine, Boston, MA, USA
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Fiedler LR, Maifoshie E, Schneider MD. Mouse models of heart failure: cell signaling and cell survival. Curr Top Dev Biol 2014; 109:171-247. [PMID: 24947238 DOI: 10.1016/b978-0-12-397920-9.00002-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Heart failure is one of the paramount global causes of morbidity and mortality. Despite this pandemic need, the available clinical counter-measures have not altered substantially in recent decades, most notably in the context of pharmacological interventions. Cell death plays a causal role in heart failure, and its inhibition poses a promising approach that has not been thoroughly explored. In previous approaches to target discovery, clinical failures have reflected a deficiency in mechanistic understanding, and in some instances, failure to systematically translate laboratory findings toward the clinic. Here, we review diverse mouse models of heart failure, with an emphasis on those that identify potential targets for pharmacological inhibition of cell death, and on how their translation into effective therapies might be improved in the future.
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Affiliation(s)
- Lorna R Fiedler
- British Heart Foundation Centre of Research Excellence, National Heart and Lung Institute, Imperial College London, London, UK.
| | - Evie Maifoshie
- British Heart Foundation Centre of Research Excellence, National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael D Schneider
- British Heart Foundation Centre of Research Excellence, National Heart and Lung Institute, Imperial College London, London, UK.
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Liu Y, Wang J, Qi SY, Ru LS, Ding C, Wang HJ, Zhao JS, Li JJ, Li AY, Wang DM. Reduced endoplasmic reticulum stress might alter the course of heart failure via caspase-12 and JNK pathways. Can J Cardiol 2013; 30:368-75. [PMID: 24565258 DOI: 10.1016/j.cjca.2013.11.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 11/03/2013] [Accepted: 12/08/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Endoplasmic reticulum (ER) stress plays an important role in mediating ischemic heart cell death. The aim of this study was to investigate whether manipulation of a key factor of the ER stress pathway, eukaryotic translation initiation factor 2 subunit α (eIF2α), can change the natural history of heart failure (HF). METHODS HF was induced using coronary artery ligation in adult rats and a selective eIF2α dephosphorylation inhibitor, salubrinal (Sal), was used. Thirty minutes after ligation, rats were randomly assigned to 3 groups: myocardial infarction (MI) plus placebo injections (dimethyl sulfoxide; n = 12), MI plus Sal injection (Sal; n = 12), and MI (HF; n = 12). Hemodynamic parameters were examined. Hearts were harvested for apoptosis assessment after 8 weeks of Sal treatment by terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labelling and flow cytometric analysis. Hearts were harvested to determine ER chaperones by Western analysis, real-time polymerase chain reaction and immunohistochemical analysis. RESULTS Cardiac function was significantly improved in Sal-treated rats. Apoptosis was reduced by Sal treatment. Glucose-regulated protein-78 and -94 were increased in HF but normalized by Sal treatment. HF caused a significant increase in eIF2α phosphorylation, which was further increased by Sal treatment, and caspase-12 and phospho-c-JUN NH2-terminal kinase were markedly increased in rats with HF alone but significantly reduced by Sal treatment. CONCLUSIONS Our results suggest that reduction of ER stress and myocardial apoptosis through inhibition of eIF2α dephosphorylation might alter the natural history of HF, which might provide a new approach for its treatment.
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Affiliation(s)
- Yu Liu
- Department of Cardiology, Peace Hospital of People's Liberation Army, Shijiazhuang, Hebei, China; Department of Biochemistry and Molecular Biology, School of Basic Medicine, Laboratory of Medical Biotechnology of Hebei Province, Hebei Traditional Chinese Medical College, Shijiazhuang, Hebei, China
| | - Jie Wang
- Division of Cardiology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Shu-Ying Qi
- Department of Cardiology, Peace Hospital of People's Liberation Army, Shijiazhuang, Hebei, China
| | - Lei-Sheng Ru
- Department of Cardiology, Peace Hospital of People's Liberation Army, Shijiazhuang, Hebei, China
| | - Chao Ding
- Department of Cardiology, Peace Hospital of People's Liberation Army, Shijiazhuang, Hebei, China
| | - Hai-Jun Wang
- Department of Surgery, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jing-Shan Zhao
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Laboratory of Medical Biotechnology of Hebei Province, Hebei Traditional Chinese Medical College, Shijiazhuang, Hebei, China
| | - Jing-Jing Li
- Department of Cardiology, Peace Hospital of People's Liberation Army, Shijiazhuang, Hebei, China
| | - Ai-Ying Li
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Laboratory of Medical Biotechnology of Hebei Province, Hebei Traditional Chinese Medical College, Shijiazhuang, Hebei, China
| | - Dong-Mei Wang
- Department of Cardiology, Peace Hospital of People's Liberation Army, Shijiazhuang, Hebei, China.
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Heart Failure in Congenital Heart Disease. Can J Cardiol 2013; 29:753-4. [DOI: 10.1016/j.cjca.2013.03.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 03/23/2013] [Accepted: 03/24/2013] [Indexed: 11/17/2022] Open
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