Dergiler / İstanbul Tıp Fakültesi Dergisi / 2025 / Cilt: 88 Sayı: 4

KONJENİTAL KALP HASTALIĞININ MOLEKÜLER TANISINDA KROMOZOMAL MİKRODİZİN BULGULARININ DEĞERLENDİRİLMESİ

ASSESSMENT OF CHROMOSOMAL MICROARRAY FINDINGS IN THE MOLECULAR DIAGNOSIS OF CONGENITAL HEART DISEASES

Gulsum Kayhan(Gazi University, Faculty of Medicine, Department of Medical Genetics)0000-0002-4286-243X
Ekin Alpaslan(Gazi University, Faculty of Medicine, Department of Medical Genetics)0000-0002-4973-5855
Semiha Tokgöz(Gazi University, Faculty of Medicine, Department of Pediatric Cardiology)3000-0000-3181-3660
Hacer Demet Özcan(Gazi University, Faculty of Medicine, Department of Medical Genetics)4000-9000-6341-5088
Fatma Hayvacı Canbeyli(Gazi University, Faculty of Medicine, Department of Pediatric Cardiology)5000-0000-3061-9075
Hasan Huseyin Kazan(University of Health Sciences, Gülhane Faculty of Medicine, Department of Medical Biology)6000-0000-1793-6860
Mehmet Ali Ergun(Gazi University, Faculty of Medicine, Department of Medical Genetics)7000-0000-1969-6043
Meral Yirmibeş Karaoğuz(Gazi University, Faculty of Medicine, Department of Medical Genetics)8000-0000-2017-8801
Sayfa
321–328
Yayın Tarihi
2025-10-30
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Katılımcılar, izole (n=25) ya da gelişme geriliği, bilişsel yetersizlik, büyüme geriliği, diğer organ anomalileri ya da dismorfik bulgular gibi ek özellikleri içeren sendromik KKH (n=88) olarak iki gruba ayrılmıştır.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Konjenital kalp hastalığı (KKH) yüksek mortalite oranlarıyla en sık karşılaşılan konjenital anomaliler arasındadır.
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Temel Bulgular & Veri:Hastalığın etkin bir şekilde yönetimi için erken tanı kritiktir.
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Sonuç & Katkı:Bulgular: Katılımcılar, izole (n=25) ya da gelişme geriliği, bilişsel yetersizlik, büyüme geriliği, diğer organ anomalileri ya da dismorfik bulgular gibi ek özellikleri içeren sendromik KKH (n=88) olarak iki gruba ayrılmıştır.
🔬Tür:Uygulamalı Anket & Alan Araştırması
📍Kapsam:12 hasta
⚙️Değişkenler:Konjenital kalp hastalığı · Kromozomal mikrodizin · Kopya sayısı varyasyonu

Özet

Amaç: Konjenital kalp hastalığı (KKH) yüksek mortalite oranlarıyla en sık karşılaşılan konjenital anomaliler arasındadır. Hastalığın etkin bir şekilde yönetimi için erken tanı kritiktir. Bu noktada, moleküler yaklaşımlar, KKH’nin erken ve ayırıcı tanısı için önem arz etmektedir. Bu çalışmada, klinik olarak KKH tanısı almış hastalarda kromozomal mikrodizin yönteminin sonuçları ve etkinliği değerlendirilmiştir Gereç ve Yöntemler: Çalışmaya Türkiye’den 113 KKH’li hasta dahil edilmiştir. Kromozomal mikrodizin, katılımcıların periferik kanından izole edilen genomik DNA ile Agilent Technologies platformu kullanılarak gerçekleştirilmiştir. İşlem sonunda varyantlar, Amerikan Tıbbi Genetik Derneği kriterleri doğrultusunda sınıflandırılmıştır. Bulgular: Katılımcılar, izole (n=25) ya da gelişme geriliği, bilişsel yetersizlik, büyüme geriliği, diğer organ anomalileri ya da dismorfik bulgular gibi ek özellikleri içeren sendromik KKH (n=88) olarak iki gruba ayrılmıştır. Kromozomal mikrodizin ile 12 hastada (%10,6) patojenik kopya sayısı değişimi (KSD) tespit edilmiştir. Bu hastaların tamamı, sendromik grupta yer almaktadır. En sık KSD, 22q11.2 bölgesinde görülmüştür. Sonuç: Bu çalışma, literatürde raporlanan sonuçları doğrulamış ve özellikle sendromik KKH vakalarında kromozomal mikrodizin yönteminin verimliliğini kanıtlamıştır. Bu çalışma, ek klinik bulgular ve daha önce bildirilmemiş CNV’lerin raporlanması ile literatüre katkı sağlamaktadır

Abstract

Objective: Congenital heart disease (CHD) is one of the most frequently encountered congenital anomalies, resulting in significant mortality ratios. Early diagnosis of CHD is critical for effective disease management. Therefore, molecular approaches could provide valuable insights into the differential and early diagnosis of CHD. In the present study, we evaluated the efficiency and outcomes of the chromosomal microarray (CMA) method in patients with clinically diagnosed CHD. Material and Methods: The study included 113 patients with CHD from a single center in Türkiye. CMA was performed using the Agilent Technologies array comparative genomic hybridisation system. Variants were classified based on the guidelines of the American College of Medical Genetics and Genomics (ACMG). Results: Participants were classified as isolated (n=25) or syndromic CHD with additional conditions, including developmental delays, intellectual disabilities, growth retardation, other organ abnormalities, or dysmorphic features (n=88). CMA identified pathogenic copy number variants (CNVs) in 12 patients (10.6%). All patients with pathogenic CNVs belonged to the syndromic group (12/88; 13.6%). The most common CNVs were in the 22q11.2 region. Additionally, three CNVs identified in two patients had unique breakpoints that had not previously been reported. Conclusion: The current study substantiated the findings reported in the literature and demonstrated the diagnostic efficacy of CMA, particularly in cases of syndromic CHD. This study is expected to offer new insights into the current literature through additional clinical findings and previously unreported CNVs.

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Bu Makaleye Atıf Yap

Kayhan, G., Alpaslan, E., Tokgöz, S., Özcan, H. D., Canbeyli, F. H., Kazan, H. H., Ergun, M. A., Karaoğuz, M. Y. (2025). KONJENİTAL KALP HASTALIĞININ MOLEKÜLER TANISINDA KROMOZOMAL MİKRODİZİN BULGULARININ DEĞERLENDİRİLMESİ. İstanbul Tıp Fakültesi Dergisi, Cilt: 88 Sayı: 4, 321–328. https://doi.org/10.26650/IUITFD.1719355

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Kaynakça (47)

  1. Van Der Bom T, Zomer AC, Zwinderman AH, Meijboom FJ, Bouma BJ, Mulder BJ. The changing epidemiology of congenital heart disease. Nat Rev Cardiol 2011;8(l):50-60. google scholar
  2. Sun R, Liu M, Lu L, Zheng Y, Zhang P. Congenital heart disease: Causes, diagnosis, symptoms, and treatments. Celi Biochem Biophys 2015;72(3):857-60. google scholar
  3. Morton SU, Quiat D, Seidman JG, Seidman CE. Genomic frontiers in congenital heart disease. Nat Rev Cardiol 2022;19(l):26-42. google scholar
  4. Eckersley L, Sadler L, Parry E, Finucane K, Gentles TL. Timing of diagnosis affects mortality in critical congenital heart disease. Arch Dis Child 2016;10l(6):516-20. google scholar
  5. Willim HA, Supit AI. Critical congenital heart disease in newborn: Early detection, diagnosis, and management. Biosci Med J Biomed Transl Res 2021;5(l):107-16. google scholar
  6. Garne E, Stoll C, Clementi M. Evaluation of prenatal diagnosis of congenital heart diseases by ultrasound: experience from 20 European registries. Ultrasound Obstet Gynecol 2001;17(5):386-91. google scholar
  7. Chitra N, Vijayalakshmi IB. Fetal echocardiography for early detection of congenital heart diseases. J Echocardiogr 2017;15(l):13-7. google scholar
  8. Richmond S, Wren C. Early diagnosis of congenital heart disease. Semin Neonatol 2001;6(l):27-35. google scholar
  9. Morrish AM, Smith J, Enriquez A, Sholler GF, Mervis J, Dunwoodie SL, et al. A new era of genetic testing in congenital heart disease: A review. Trends Cardiovasc Med 2022;32(5):311-9. google scholar
  10. Yasuhara J, Garg V. Genetics of congenital heart disease: A narrative review of recent advances and clinical implications. Transl Pediatr 2021;10(9):2366-86. google scholar
  11. Williams K, Carson J, Lo C. Genetics of congenital heart disease. Biomolecules 2019;9(12):879. google scholar
  12. Blue GM, Kirk EP, Giannoulatou E, Sholler GF, Dunwoodie SL, Harvey RP, et al. Advances in the genetics of congenital heart disease: A clinician’s guide. J Am Coll Cardiol 2017;69(7):859-70. google scholar
  13. Cowan JR, Ware SM. Genetics and genetic testing in congenital heart disease. Clin Perinatol 2015;42(2):373-93. google scholar
  14. Muntean I, Toganel R, Benedek T. Genetics of congenital heart disease: past and present. Biochem Genet 2017;55(2):105-23. google scholar
  15. Zaidi S, Brueckner M. Genetics and genomics of congenital heart disease. Cir Res 2017;120(6):923-40. google scholar
  16. Rezapour A, Souresrafl A, Barzegar M, Sheikhy-Chaman M, Tatarpour P, Economic evaluation of next-generation sequencing techniques in diagnosis of genetic disorders: A systematic review. Clin Genet 2023;103(5):513-28. google scholar
  17. Geng J, Picker J, Zheng Z, Zhang X, Wang J, Hisama F, et al. Chromosome microarray testing for patients with congenital heart defects reveals novel disease causing loci and high diagnostic yield. BMC Genomics 2014;15(1):1127. google scholar
  18. Wu XL, Li R, Fu F, Pan M, Han J, Yang X, et al. Chromosome microarray analysis in the investigation of children with congenital heart disease. BMC Pediatr 2017;17(1):117 google scholar
  19. Shanshen E, Rosenberg J, Van Bergen AH. Identification of novel congenital heart disease candidate genes using chromosome microarray. Pediatr Cardiol 2018;39(l):148-59. google scholar
  20. Gill K, Sasaki J, Jayakar P, Sosa L, Welch E. Chromosomal microarray detects genetic risks of neurodevelopmental disorders in newborns with congenital heart disease. Cardiol Young 2021;3l(8):1275-82. google scholar
  21. Landis BJ, Helvaty LR, Geddes GC, Lin JH, Yatsenko SA, Lo CW, et al. A multicenter analysis of abnormal chromosomal microarray findings in congenital heart disease. J Am Heart Assoc 2023;12(18):e029340. google scholar
  22. Yoon PW, Rasmussen SA, Lynberg MC, Moore CA, Anderka M, Carmichael SL, et al. The national birth defects prevention study. Public Health Rep 2001;116(Suppl 1):32-4O. google scholar
  23. Michaud V, Lasseaux E, Green DJ, Gerrard DT, Plaisant C, UK Biobank Eye and Vision Consortium, et al. The contribution of common regulatory and protein-coding TYR variants to the genetic architecture of albinism. Nat Commun 2022;13(1):3939. google scholar
  24. Zhu X, Li J, Ru T, Wang Y, Xu Y, Yang Y, et al. Identification of copy number variations associated with congenital heart disease by chromosomal microarray analysis and next-generation sequencing. Prenat Diagn 2016;36(4):321-7. google scholar
  25. Riggs ER, Andersen EF, Cherry AM, Kantarci S, Kearney H, Patel A, et al. Technical standards for the interpretation and reporting of constitutional copy-number variants: A joint consensus recommendation of the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClİnGen). Genet Med 2020;22(2):245-57. google scholar
  26. Murni IK, Wirawan MT, Patmasari L, Sativa ER, Arafuri N, Nugroho S, et al. Delayed diagnosis in children with congenital heart disease: A mixed-method study. BMC Pediatr 2021;21(1):191. google scholar
  27. Menahem S, Sehgal A, Meagher S. Early detection of significant congenital heart disease: The contribution of fetal cardiac ultrasound and newborn pulse oximetry sereening. J Pediatr Child Health 2021;57(3):323-7. google scholar
  28. Taksande A, Jameel PZ. Critical congenital heart disease in neonates: A review article. Curr Pediatr Rev 2021;17(2):120-6. google scholar
  29. Rachamadugu SI, Miller KA, Lee IH, Zou YS. Genetic detection of congenital heart disease. Gynecol Obstet Clin Med 2022;2(3):109-23. google scholar
  30. Hitz MP, Dombrowsky G, Melnik N, Vey C. Current and future diagnostics of congenital heart disease (CHD). Med Genet 2025;37(2):95-102. google scholar
  31. Diz OM, Toro R, Cesar S, Gomez O, Sarquella-Brugada G, Campuzano O. Personalized genetic diagnosis of congenital heart defects in newborns. J Pers Med 2021;11(6):562. google scholar
  32. Ko JM. Genetic syndromes associated with congenital heart disease. Korean Circ J 2015;45(5):357-61. google scholar
  33. Gawde H, Patel ZM, Khatkhatey MI, D'Souza A, Babu S, Adhia R, et al. Chromosome 22 microdeletion by FISH in isolated congenital heart disease. Indian J Pediatr 2006;73(l0):885-8. google scholar
  34. Trevisan P, Rosa RF, Koshiyama DB, Zen TD, Paskulin GA, Zen PR. Congenital heart disease and chromossomopathies detected by the karyotype. Rev Paul Pediatr 2014;32(2):262-71. google scholar
  35. Geddes GC, Butterly M, Sajan I. FISH for 22q11. 2 deletion not eost-effeetive for infants with congenital heart disease with microarray. Pediatr Cardiol 2015;36(3):531-6. google scholar
  36. Pierpont ME, Brueckner M, Chung WK, Garg V, Lacro RV, McGuire AL, et al. Genetic basis for congenital heart disease: revisited: A scientific statement from the American Heart Association. Circulation 2018;138(2l):e653-711. google scholar
  37. Şentürk H, Selçuk BÖ, Sivrikoz TS, Kalaycı T, Ömeroğlu RN, et al. Kardiyak anomalili fetüslerde kromozomal mikrodizin analizinin tanıdaki etkinliği: Kohort araştırması. Türkiye Klinikleri J Med Sc 2023;43(3):302-13. google scholar
  38. Rosias PP, Sijstermans JM, Theunissen PM, Pulles-Heintzberger CF, De Die-Smulders CE, Engelen JJ, et al. Phenotypic variability of the cat eye syndrome. Case report and review of the literatüre. Genet Couns 2001;12(3):273-82. google scholar
  39. Ishikawa A, Enomoto K, Tominaga M, Saito T, Nagai JI, Furuya N, et al. Pure duplication of 19p13. 3. Am J Med Genet A 2013;161A(9):2300-4. google scholar
  40. Ji T, Wu Y, Wang H, Wang J, Jiang Y. Diagnosis and fine mapping of a deletion in distal 11q in two Chinese patients with developmental delay. J Hum Genet 2010;55(8):486-9. google scholar
  41. van Trier DC, Feenstra I, Bot P, de Leeuw N, Draaisma JM. Cardiac anomalies in individuals with the 18q deletion syndrome; report of a child with Ebstein anomaly and review of the literatüre. Eur J Med Genet 2013;56(8):426-31. google scholar
  42. Digilio MC, Bernardini L, Lepri F, Giuffrida MG, Guida V, Baban A, et al. Ebstein anomaly: Genetic heterogeneity and association with microdeletions 1p36 and 8p23. 1. Am J Med Genet A 2011;155A(9):2196-202. google scholar
  43. Plaiasu V, Ochiana D, Motei G, Georgescu A. A rare chromosomal disorder-isochromosome 18p syndrome. Maedica 2011;6(2):132-6. google scholar
  44. Nur BG, Clark OA, Cetin Z, Toylu AS, Karauzum SB, Mihci E. The clinical spectrum of a rare chromosomal abnormality: isochromosome 18p. Genet Couns 2016;27(2):223-31. google scholar
  45. Rosenfeld JA, Coppinger J, Bejjani BA, Girirajan S, Eichler EE, Shaffer LG, et al. Speech delays and behavioral problems are the predominant features in individuals with developmental delays and 16p11. 2 microdeletions and microduplications. J Neurodev Disord 2010;2(l):26-38. google scholar
  46. Nascimento LP, Mergener R, Nunes MR, Muniz VF, Catao JR, Silveira AK, et al. 16p11. 2 Microduplication Syndrome with Increased Fluid in the Cisterna: Coincidence or Phenotype Extension? Genes 2023;14(8):1583. google scholar
  47. Karunanithi Z, Vestergaard EM, Lauridsen MH. Transposition of the great arteries-a phenotype Associated with 16p11. 2 duplications? World J Cardiol 2017;9(l2):848-52. google scholar