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ORIGINAL ARTICLES |
1 Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
2 Department of Molecular and Medical Genetics, and OHSU Heart Research Center, Oregon Health & Science University, Portland, Oregon, USA
3 Department of Medical Informatics and Clinical Epidemiology, and OHSU Heart Research Center, Oregon Health & Science University, Portland, Oregon, USA
4 Departments of Pediatrics and Molecular Biology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
Correspondence to:
E Goldmuntz, MD, Division of Cardiology, The Children’s Hospital of Philadelphia, Abramson Research Center 702A, 3615 Civic Center Blvd, Philadelphia, Pennsylvania 19104, USA; goldmuntz{at}email.chop.edu]
Background: Recent reports have identified mutations in the transcription factor GATA4 in familial cases of cardiac septal defects. The prevalence of GATA4 mutations in the population of patients with septal defects is unknown. Given that patients with septal and conotruncal defect can share a common genetic basis, it is unclear whether patients with additional types of CHD might also have GATA4 mutations.
Aims: To explore these questions by investigating a large population of 628 patients with either septal or conotruncal defects for GATA4 sequence variants.
Methods: The GATA4 coding region and exon–intron boundaries were investigated for sequence variants using denaturing high-performance liquid chromatography or conformation-sensitive gel electrophoresis. Samples showing peak or band shifts were reamplified from genomic DNA and sequenced.
Results: Four missense sequence variants (Gly93Ala, Gln316Glu, Ala411Val, Asp425Asn) were identified in five patients (two with atrial septal defect, two with ventricular septal defect and one with tetralogy of Fallot), which were not seen in a control population. All four affected amino acid residues are conserved across species, and two of the sequence variants lead to changes in polarity. Ten synonymous sequence variants were also identified in 18 patients, which were not seen in the control population.
Conclusions: These data suggest that non-synonymous GATA4 sequence variants are found in a small percentage of patients with septal defects and are very uncommonly found in patients with conotruncal defects.
Abbreviations: ASD, atrial septal defect; CHD, congenital heart disease; DHPLC, denaturing high-performance liquid chromatography; CSGE, conformation-sensitive gel electrophoresis; DORV, double-outlet right ventricle; D-TGA, D-transposition of the great arteries; ESE, exonic splice enhancer; IAA, interrupted aortic arch; L-TGA, L-transposition of the great arteries; TA, truncus arteriosus; TOF, tetralogy of Fallot; VSD, ventricular septal defect
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