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  1. Article ; Online: 22q11.2 deletion syndrome and congenital heart disease.

    Goldmuntz, Elizabeth

    American journal of medical genetics. Part C, Seminars in medical genetics

    2020  Volume 184, Issue 1, Page(s) 64–72

    Abstract: The 22q11.2 deletion syndrome has an estimated prevalence of 1 in 4-6,000 livebirths. The phenotype varies widely; the most common features include: facial dysmorphia, hypocalcemia, palate and speech disorders, feeding and gastrointestinal disorders, ... ...

    Abstract The 22q11.2 deletion syndrome has an estimated prevalence of 1 in 4-6,000 livebirths. The phenotype varies widely; the most common features include: facial dysmorphia, hypocalcemia, palate and speech disorders, feeding and gastrointestinal disorders, immunodeficiency, recurrent infections, neurodevelopmental and psychiatric disorders, and congenital heart disease. Approximately 60-80% of patients have a cardiac malformation most commonly including a subset of conotruncal defects (tetralogy of Fallot, truncus arteriosus, interrupted aortic arch type B), conoventricular and/or atrial septal defects, and aortic arch anomalies. Cardiac patients with a 22q11.2 deletion do not generally experience higher mortality upon surgical intervention but suffer more peri-operative complications than their non-syndromic counterparts. New guidelines suggest screening for a 22q11.2 deletion in the patient with tetralogy of Fallot, truncus arteriosus, interrupted aortic arch type B, conoventricular septal defects as well as those with an isolated aortic arch anomaly. Early identification of a 22q11.2 deletion in the neonate or infant when other syndromic features may not be apparent allows for timely parental screening for reproductive counseling and anticipatory evaluation of cardiac and noncardiac features. Screening the at-risk child or adult allows for important age-specific clinical, neurodevelopmental, psychiatric, and reproductive issues to be addressed.
    MeSH term(s) Aorta, Thoracic/abnormalities ; Aorta, Thoracic/pathology ; Arachnodactyly/complications ; Arachnodactyly/epidemiology ; Arachnodactyly/genetics ; Chromosome Deletion ; Craniosynostoses/complications ; Craniosynostoses/epidemiology ; Craniosynostoses/genetics ; DiGeorge Syndrome/complications ; DiGeorge Syndrome/epidemiology ; DiGeorge Syndrome/genetics ; Guidelines as Topic ; Heart Defects, Congenital/complications ; Heart Defects, Congenital/epidemiology ; Heart Defects, Congenital/genetics ; Humans ; In Situ Hybridization, Fluorescence ; Marfan Syndrome/complications ; Marfan Syndrome/epidemiology ; Marfan Syndrome/genetics ; Tetralogy of Fallot/complications ; Tetralogy of Fallot/epidemiology ; Tetralogy of Fallot/genetics ; Truncus Arteriosus/pathology
    Language English
    Publishing date 2020-02-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2108622-9
    ISSN 1552-4876 ; 0148-7299 ; 1552-4868
    ISSN (online) 1552-4876
    ISSN 0148-7299 ; 1552-4868
    DOI 10.1002/ajmg.c.31774
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Familial Aggregation Studies: A Valuable Tool in the Genetic Toolbox.

    Goldmuntz, Elizabeth / Mitchell, Laura E

    Circulation. Genomic and precision medicine

    2022  Volume 15, Issue 4, Page(s) e003868

    MeSH term(s) Genetic Counseling ; Genetic Testing ; Humans
    Language English
    Publishing date 2022-08-02
    Publishing country United States
    Document type Editorial ; Comment
    ISSN 2574-8300
    ISSN (online) 2574-8300
    DOI 10.1161/CIRCGEN.122.003868
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Invited Commentary: The Hunt for Mechanistic Origins of Liver Fibrosis in the Fontan Circulation.

    Rychik, Jack / Goldmuntz, Elizabeth

    World journal for pediatric & congenital heart surgery

    2021  Volume 12, Issue 2, Page(s) 173–175

    MeSH term(s) Fontan Procedure/adverse effects ; Humans ; Liver ; Liver Cirrhosis/etiology
    Language English
    Publishing date 2021-03-08
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2550261-X
    ISSN 2150-136X ; 2150-1351
    ISSN (online) 2150-136X
    ISSN 2150-1351
    DOI 10.1177/2150135121989974
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Exercise is medicine in the Fontan circulation.

    Avitabile, Catherine / Goldmuntz, Elizabeth / Rychik, Jack

    International journal of cardiology

    2021  Volume 343, Page(s) 50–52

    MeSH term(s) Exercise ; Exercise Tolerance ; Fontan Procedure ; Humans
    Language English
    Publishing date 2021-09-16
    Publishing country Netherlands
    Document type Editorial ; Comment
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2021.09.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Reported practice patterns in the ambulatory care setting for patients with CHD.

    Goldmuntz, Elizabeth / Zheng, Zihe / Shea, Judy A

    Cardiology in the young

    2021  , Page(s) 1–6

    Abstract: Introduction: In the absence of evidence-based guidelines, paediatric cardiologists monitor patients in the ambulatory care setting largely according to personal, patient, institutional, and/or financial dictates, all of which likely contribute to ... ...

    Abstract Introduction: In the absence of evidence-based guidelines, paediatric cardiologists monitor patients in the ambulatory care setting largely according to personal, patient, institutional, and/or financial dictates, all of which likely contribute to practice variability. Minimising practice variability may optimise quality of care while incurring lower costs. We sought to describe self-reported practice patterns and physician attitudes about factors influencing their testing strategies using vignettes describing common scenarios in the care of asymptomatic patients with tetralogy of Fallot and d-transposition of the great arteries.
    Methods: We conducted a cross-sectional survey of paediatric cardiologists attending a Continuing Medical Educational conference and at our centre. The survey elicited physician characteristics, self-reported testing strategies, and reactions to factors that might influence their decision to order an echocardiogram.
    Results: Of 267 eligible paediatric cardiologists, 110 completed the survey. The majority reported performing an annual physical examination (66-82%), electrocardiogram (74-79%), and echocardiogram (56-76%) regardless of patient age or severity of disease. Other tests (i.e. Holter monitors, exercise stress tests or cardiac MRIs) were ordered less frequently and less consistently. We observed within physician consistency in frequency of test ordering. In vignettes of younger children with mild disease, higher frequency testers were younger than lower frequency testers.
    Conclusions: These results suggest potential practice pattern variability, which needs to be further explored in real-life settings. If clinical outcomes for patients followed by low frequency testers match that of high frequency testers, then room to modify practice patterns and lower costs without compromising quality of care may exist.
    Language English
    Publishing date 2021-11-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951121004303
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Maternal effect genes as risk factors for congenital heart defects.

    Musfee, Fadi I / Oluwafemi, Omobola O / Agopian, A J / Hakonarson, Hakon / Goldmuntz, Elizabeth / Mitchell, Laura E

    HGG advances

    2022  Volume 3, Issue 2, Page(s) 100098

    Abstract: Maternal effect genes (MEGs) encode factors (e.g., RNA) in the oocyte that control embryonic development prior to activation of the embryonic genome. Over 80 mammalian MEGs have been identified, including several that have been associated with phenotypes ...

    Abstract Maternal effect genes (MEGs) encode factors (e.g., RNA) in the oocyte that control embryonic development prior to activation of the embryonic genome. Over 80 mammalian MEGs have been identified, including several that have been associated with phenotypes in humans. Maternal variation in MEGs is associated with a range of adverse outcomes, which, in humans, include hydatidiform moles, zygotic cleavage failure, and offspring with multi-locus imprinting disorders. In addition, data from both animal models and humans suggest that the MEGs may be associated with structural birth defects such as congenital heart defects (CHDs). To further investigate the association between MEGs and CHDs, we conducted gene-level and gene-set analyses of known mammalian MEGs (n = 82) and two common groups of CHDs: conotruncal heart defects and left ventricular outflow tract defects. We identified 14 candidate CHD-related MEGs. These 14 MEGs include three (
    Language English
    Publishing date 2022-03-09
    Publishing country United States
    Document type Journal Article
    ISSN 2666-2477
    ISSN (online) 2666-2477
    DOI 10.1016/j.xhgg.2022.100098
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Parental Impressions and Perspectives of Efficacy in Prenatal Counseling for Single Ventricle Congenital Heart Disease.

    Houlihan, Taylor Hartzel / Combs, Jill / Smith, Elizabeth / Coulter, Elizabeth / Figueroa, Lucia / Falkensammer, Christine / Savla, Jill / Goldmuntz, Elizabeth / Degenhardt, Karl / Szwast, Anita / Shillingford, Amanda / Rychik, Jack

    Pediatric cardiology

    2023  Volume 45, Issue 3, Page(s) 605–613

    Abstract: Although commonly performed, optimal techniques, strategies, and content to achieve the most effective prenatal counseling have not been explored. We investigate the efficacy of prenatal counseling via survey feedback of parents of children with ... ...

    Abstract Although commonly performed, optimal techniques, strategies, and content to achieve the most effective prenatal counseling have not been explored. We investigate the efficacy of prenatal counseling via survey feedback of parents of children with prenatally diagnosed single ventricle. Grades of counseling using a Likert scale (1-5) were solicited to assess: (1) overall impression of quantity of counseling, (2) explanation of the heart defect, (3) preparation for heart surgery, (4) preparation for hospital course and care, (5) preparation for complications and outcomes of a Fontan circulation, and (6) preparation for neurological, school-related, or behavioral problems. Impressions were solicited concerning specific providers. A comprehensive fetal counseling score was calculated for each participant. Burden of care including length of hospitalization was explored as impacting prenatal counseling grades. There were 59 survey respondents. Average age of the children at the time of survey was 4.6 ± 3.3 years (range 1-10 years). Highest grades were for explanation of the heart condition, with lowest grades for preparation for neurological, school-related, or behavioral problems. Cardiac surgeon received the highest with social worker lowest grade for provider. Negative correlation was found between the composite fetal counseling score and parental recollection of length of hospitalization (Pearson r = - 0.357, p < 0.01). Prenatal counseling for neurological, school-related, and behavioral problems in single ventricle is deficient. Further studies analyzing prenatal counseling techniques and content can help improve upon the delivery of this important aspect of prenatal care.
    MeSH term(s) Pregnancy ; Child ; Female ; Humans ; Infant ; Child, Preschool ; Heart Defects, Congenital/surgery ; Heart Defects, Congenital/diagnosis ; Prenatal Care ; Univentricular Heart ; Fontan Procedure ; Parents/psychology ; Counseling/methods ; Prenatal Diagnosis ; Ultrasonography, Prenatal
    Language English
    Publishing date 2023-12-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800857-7
    ISSN 1432-1971 ; 0172-0643
    ISSN (online) 1432-1971
    ISSN 0172-0643
    DOI 10.1007/s00246-023-03355-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Prenatal cardiac findings and 22q11.2 deletion syndrome: Fetal detection and evaluation.

    Goldmuntz, Elizabeth / Bassett, Anne S / Boot, Erik / Marino, Bruno / Moldenhauer, Julie S / Óskarsdóttir, Sólveig / Putotto, Carolina / Rychik, Jack / Schindewolf, Erica / McDonald-McGinn, Donna M / Blagowidow, Natalie

    Prenatal diagnosis

    2024  

    Abstract: Clinical features of 22q11.2 microdeletion syndrome (22q11.2DS) are highly variable between affected individuals and frequently include a subset of conotruncal and aortic arch anomalies. Many are diagnosed with 22q11.2DS when they present as a fetus, ... ...

    Abstract Clinical features of 22q11.2 microdeletion syndrome (22q11.2DS) are highly variable between affected individuals and frequently include a subset of conotruncal and aortic arch anomalies. Many are diagnosed with 22q11.2DS when they present as a fetus, newborn or infant with characteristic cardiac findings and subsequently undergo genetic testing. The presence of an aortic arch anomaly with characteristic intracardiac anomalies increases the likelihood that the patient has 22q11.2 DS, but those with an aortic arch anomaly and normal intracardiac anatomy are also at risk. It is particularly important to identify the fetus at risk for 22q11.2DS in order to prepare the expectant parents and plan postnatal care for optimal outcomes. Fetal anatomy scans now readily identify aortic arch anomalies (aberrant right subclavian artery, right sided aortic arch or double aortic arch) in the three-vessel tracheal view. Given the association of 22q11.2DS with aortic arch anomalies with and without intracardiac defects, this review highlights the importance of recognizing the fetus at risk for 22q11.2 deletion syndrome with an aortic arch anomaly and details current methods for genetic testing. To assist in the prenatal diagnosis of 22q11.2DS, this review summarizes the seminal features of 22q11.2DS, its prenatal presentation and current methods for genetic testing.
    Language English
    Publishing date 2024-04-09
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 82031-3
    ISSN 1097-0223 ; 0197-3851
    ISSN (online) 1097-0223
    ISSN 0197-3851
    DOI 10.1002/pd.6566
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Marked skeletal muscle deficits are associated with 6-minute walk distance in paediatric pulmonary hypertension.

    Avitabile, Catherine M / Saavedra, Sofia / Sivakumar, Nithya / Goldmuntz, Elizabeth / Paridon, Stephen M / Zemel, Babette S

    Cardiology in the young

    2021  Volume 31, Issue 9, Page(s) 1426–1433

    Abstract: Background: Poor growth is common in children with pulmonary hypertension; however, skeletal muscle deficits have not been described and the association between muscle deficits and functional status is unknown.: Methods: Patients aged 8-18 years with ...

    Abstract Background: Poor growth is common in children with pulmonary hypertension; however, skeletal muscle deficits have not been described and the association between muscle deficits and functional status is unknown.
    Methods: Patients aged 8-18 years with pulmonary hypertension (diagnostic Groups 1, 2, or 3) and World Health Organization functional class I or II underwent dual-energy absorptiometry to measure leg lean mass Z-score (a surrogate for skeletal muscle). Muscle strength was assessed using dynamometry. Physical activity questionnaires were administered. Clinical data, including 6-minute walk distance, were reviewed. Relationships between skeletal muscle, physical activity score, and 6-minute walk distance were assessed by correlations and linear regression.
    Results: Sixteen patients (12.1 ± 3.2 years, 50% female, 56% Group 1, 56% functional class II) were enrolled. Leg lean mass Z-score was significantly less than reference data (-1.40 ± 1.12 versus 0.0 ± 0.9, p < 0.001) and worse in those with functional class II versus I (-2.10 ± 0.83 versus -0.50 ± 0.73, p < 0.01). Leg lean mass Z-score was positively associated with right ventricular systolic function by tricuspid annular plane systolic Z-score (r = 0.54, p = 0.03) and negatively associated with indexed pulmonary vascular resistance (r = -0.78, p < 0.001). Leg lean mass Z-score and forearm strength were positively associated with physical activity score. When physical activity score was held constant, leg lean mass Z-score independently predicted 6-minute walk distance (R2 = 0.39, p = 0.03).
    Conclusions: Youth with pulmonary hypertension demonstrate marked skeletal muscle deficits in association with exercise intolerance. Future studies should investigate whether low leg lean mass is a marker of disease severity or an independent target that can be improved.
    MeSH term(s) Adolescent ; Body Composition ; Child ; Female ; Humans ; Hypertension, Pulmonary ; Male ; Muscle Strength ; Muscle, Skeletal ; Walking
    Language English
    Publishing date 2021-02-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951121000342
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Gene-Interaction-Sensitive enrichment analysis in congenital heart disease.

    Woodward, Alexa A / Taylor, Deanne M / Goldmuntz, Elizabeth / Mitchell, Laura E / Agopian, A J / Moore, Jason H / Urbanowicz, Ryan J

    BioData mining

    2022  Volume 15, Issue 1, Page(s) 4

    Abstract: Background: Gene set enrichment analysis (GSEA) uses gene-level univariate associations to identify gene set-phenotype associations for hypothesis generation and interpretation. We propose that GSEA can be adapted to incorporate SNP and gene-level ... ...

    Abstract Background: Gene set enrichment analysis (GSEA) uses gene-level univariate associations to identify gene set-phenotype associations for hypothesis generation and interpretation. We propose that GSEA can be adapted to incorporate SNP and gene-level interactions. To this end, gene scores are derived by Relief-based feature importance algorithms that efficiently detect both univariate and interaction effects (MultiSURF) or exclusively interaction effects (MultiSURF*). We compare these interaction-sensitive GSEA approaches to traditional χ
    Results: In the simulation study and for both CTD datasets, both Relief-based approaches to GSEA captured more relevant and significant gene ontology terms compared to the univariate GSEA. Key terms and themes of interest include cell adhesion, migration, and signaling. A leading edge analysis highlighted semaphorins and their receptors, the Slit-Robo pathway, and other genes with roles in the secondary heart field and outflow tract development.
    Conclusions: Our results indicate that interaction-sensitive approaches to enrichment analysis can improve upon traditional univariate GSEA. This approach replicated univariate findings and identified additional and more robust support for the role of the secondary heart field and cardiac neural crest cell migration in the development of CTDs.
    Language English
    Publishing date 2022-02-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2438773-3
    ISSN 1756-0381
    ISSN 1756-0381
    DOI 10.1186/s13040-022-00287-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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