Key result
Secundum ASD is linked to a ~3-fold higher rate of familial congenital heart disease.
Why the study?
Is there a higher familial recurrence of congenital heart disease in patients with ostium secundum atrial septal defect compared to healthy subjects?
Case-Control (n=991)
No
Is there a higher familial recurrence of congenital heart disease in patients with ostium secundum atrial septal defect compared to healthy subjects?
Answers are grounded in this paper and cite their sources.
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“Although consanguinity cannot be excluded in either cases or controls, this study emphasizes the role of genetic factors in the determination of CHD, particularly OSASD. Further assessment of the predictive value of positive family history could lead to selection of families with a predisposition for CHD.”
Patients with ostium secundum atrial septal defect have a significantly higher familial recurrence of congenital heart disease compared to healthy subjects, highlighting the role of genetic factors.
AIMS: Ostium secundum atrial septal defect (osASD) is one of the most common cardiac malformations. Few data are available on the familial recurrence of congenital heart disease (CHD), in particular, in a large group of patients with isolated osASD. The aim is to investigate the familial recurrence of CHD in up to third-degree relatives from a large sample of consecutively enrolled patients with osASD, taking into account the influence of degree of relatedness (as number of relatives). METHODS AND RESULTS: From January 1998 to December 2002, we enrolled 583 patients with osASD and 408 healthy subjects, referred to our tertiary centre. We hypothesized that a positive family history required at least one relative with CHD to constitute a risk factor. In this model of analysis, the null hypothesis is a similar familial history between cases and controls. Among 583 patients with osASD, 109 (19%) had at least one relative with CHD. Among the 408 healthy subjects studied, only 23 (6%) had a family history of CHD. A familial recurrence of CHD was demonstrated in 72 of 312 (23%) patients with isolated osASD and in 37 of 271 (13.6%) patients with non-isolated osASD. Familial recurrence of isolated osASD was demonstrated in 22 of 312 patients (7%) with an isolated osASD and only in six of 271 patients (2.2%) with non-isolated osASD. The familial recurrence risk of isolated osASD in patients with isolated osASD was higher in sibs, especially in sisters (33.3%). CONCLUSION: This study underscores the role of genetic factors in the determination of CHD, particularly osASD. Our results could represent the basis for further studies to calculate a 'value of family history' to adapt the familial recurrence to the real size of each family group. In this way, we could select families with a 'tendency' to develop CHD, particularly osASD. In these families, we could analyse the genetic pattern to establish abnormalities and the bases of CHD.
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Caputo et al. (2005) conducted a case-control in Ostium secundum atrial septal defect (osASD) (n=991). Ostium secundum atrial septal defect (osASD) vs. Healthy subjects was evaluated on At least one relative with congenital heart disease. Patients with ostium secundum atrial septal defect had a higher prevalence of a family history of congenital heart disease compared to healthy subjects (19% vs 6%).
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