Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.

Ebstein anomaly (EA) is a rare heart defect in which the tricuspid valve is malformed and displaced. The tricuspid valve abnormalities can lead to backflow of blood from the right ventricle to the right atrium, preventing proper circulation of blood to the lungs. Although the etiology of EA is large...

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Main Authors: Robert J Sicko, Marilyn L Browne, Shannon L Rigler, Charlotte M Druschel, Gang Liu, Ruzong Fan, Paul A Romitti, Michele Caggana, Denise M Kay, Lawrence C Brody, James L Mills
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0165174
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author Robert J Sicko
Marilyn L Browne
Shannon L Rigler
Charlotte M Druschel
Gang Liu
Ruzong Fan
Paul A Romitti
Michele Caggana
Denise M Kay
Lawrence C Brody
James L Mills
author_facet Robert J Sicko
Marilyn L Browne
Shannon L Rigler
Charlotte M Druschel
Gang Liu
Ruzong Fan
Paul A Romitti
Michele Caggana
Denise M Kay
Lawrence C Brody
James L Mills
author_sort Robert J Sicko
collection DOAJ
description Ebstein anomaly (EA) is a rare heart defect in which the tricuspid valve is malformed and displaced. The tricuspid valve abnormalities can lead to backflow of blood from the right ventricle to the right atrium, preventing proper circulation of blood to the lungs. Although the etiology of EA is largely unresolved, increased prevalence of EA in those with a family history of congenital heart disease suggests EA has a genetic component. Copy number variants (CNVs) are a major source of genetic variation and have been implicated in a range of congenital heart defect phenotypes. We performed a systematic, genome-wide search for CNVs in 47 isolated EA cases using genotyping microarrays. In addition, we used a custom HaloPlex panel to sequence three known EA genes and 47 candidate EA genes. We identified 35 candidate CNVs in 24 (51%) EA cases. Rare sequence variants in genes associated with cardiomyopathy were identified in 11 (23%) EA cases. Two CNVs near the transcriptional repressor HEY1, a member of the NOTCH signaling pathway, were identified in three unrelated cases. All other candidate CNVs were each identified in a single case. At least 11 of 35 candidate CNVs include genes involved in myocardial development or function, including multiple genes in the BMP signaling pathway. We identified enrichment of gene sets involved in histone modification and cardiomyocyte differentiation, supporting the involvement of the developing myocardium in the etiology of EA. Gene set enrichment analysis also identified ribosomal RNA processing, a potentially novel pathway of altered cardiac development in EA. Our results suggest an altered myocardial program may contribute to abnormal tricuspid valve development in EA. Future studies should investigate abnormal differentiation of cardiomyocytes as a potential etiological factor in EA.
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spelling doaj.art-1d80d22aa59444f3a9e595901a5f3aba2023-07-29T05:31:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011110e016517410.1371/journal.pone.0165174Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.Robert J SickoMarilyn L BrowneShannon L RiglerCharlotte M DruschelGang LiuRuzong FanPaul A RomittiMichele CagganaDenise M KayLawrence C BrodyJames L MillsEbstein anomaly (EA) is a rare heart defect in which the tricuspid valve is malformed and displaced. The tricuspid valve abnormalities can lead to backflow of blood from the right ventricle to the right atrium, preventing proper circulation of blood to the lungs. Although the etiology of EA is largely unresolved, increased prevalence of EA in those with a family history of congenital heart disease suggests EA has a genetic component. Copy number variants (CNVs) are a major source of genetic variation and have been implicated in a range of congenital heart defect phenotypes. We performed a systematic, genome-wide search for CNVs in 47 isolated EA cases using genotyping microarrays. In addition, we used a custom HaloPlex panel to sequence three known EA genes and 47 candidate EA genes. We identified 35 candidate CNVs in 24 (51%) EA cases. Rare sequence variants in genes associated with cardiomyopathy were identified in 11 (23%) EA cases. Two CNVs near the transcriptional repressor HEY1, a member of the NOTCH signaling pathway, were identified in three unrelated cases. All other candidate CNVs were each identified in a single case. At least 11 of 35 candidate CNVs include genes involved in myocardial development or function, including multiple genes in the BMP signaling pathway. We identified enrichment of gene sets involved in histone modification and cardiomyocyte differentiation, supporting the involvement of the developing myocardium in the etiology of EA. Gene set enrichment analysis also identified ribosomal RNA processing, a potentially novel pathway of altered cardiac development in EA. Our results suggest an altered myocardial program may contribute to abnormal tricuspid valve development in EA. Future studies should investigate abnormal differentiation of cardiomyocytes as a potential etiological factor in EA.https://doi.org/10.1371/journal.pone.0165174
spellingShingle Robert J Sicko
Marilyn L Browne
Shannon L Rigler
Charlotte M Druschel
Gang Liu
Ruzong Fan
Paul A Romitti
Michele Caggana
Denise M Kay
Lawrence C Brody
James L Mills
Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.
PLoS ONE
title Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.
title_full Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.
title_fullStr Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.
title_full_unstemmed Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.
title_short Genetic Variants in Isolated Ebstein Anomaly Implicated in Myocardial Development Pathways.
title_sort genetic variants in isolated ebstein anomaly implicated in myocardial development pathways
url https://doi.org/10.1371/journal.pone.0165174
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