Abstract
Tricuspid atresia (TA) is a rare congenital heart condition that presents with a complete absence of the right atrioventricular valve. Because of the rarity of familial and/or isolated cases of TA, little is known about the potential genetic abnormalities contributing to this condition. Potential responsible chromosomal abnormalities were identified in exploratory studies and include deletions in 22q11, 4q31, 8p23, and 3p as well as trisomies 13 and 18. In parallel, potential culprit genes include the ZFPM2, HEY2, NFATC1, NKX2-5, MYH6, and KLF13 genes. The aim of this chapter is to expose the genetic components that are potentially involved in the pathogenesis of TA in humans. The large variability in phenotypes and genotypes among cases of TA suggests a genetic network that involves many components yet to be unraveled.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–900.
Grant JW. Congenital malformations of the tricuspid valve in siblings. Pediatr Cardiol. 1996;17:327–9.
Lin AE, Rosti L. Tricuspid atresia in sibs. J Med Genet. 1998;35:1055–6.
Bonnet D, Fermont L, Kachaner J, et al. Tricuspid atresia and conotruncal malformations in five families. J Med Genet. 1999;36:349–50.
Rao PS. Consensus on timing of intervention for common congenital heart diseases: part II – cyanotic heart defects. Indian J Pediatr. 2013;80:663–74.
Rao PS. Consensus on timing of intervention for common congenital heart diseases: part I – acyanotic heart defects. Indian J Pediatr. 2013;80:32–8.
Benson DW, Basson CT, MacRae CA. New understandings in the genetics of congenital heart disease. Curr Opin Pediatr. 1996;8:505–11.
Fischer A, Klamt B, Schumacher N, et al. Phenotypic variability in Hey2 −/− mice and absence of HEY2 mutations in patients with congenital heart defects or Alagille syndrome. Mamm Genome. 2004;15:711–6.
El-Rassy I, Bou-Abdallah J, Al-Ghadban S, et al. Absence of NOTCH2 and Hey2 mutations in a familial Alagille syndrome case with a novel frameshift mutation in JAG1. Am J Med Genet A. 2008;146:937–9.
Wirrig EE, Yutzey KE. Transcriptional regulation of heart valve development and disease. Cardiovasc Pathol. 2011;20:162–7.
Garry DJ, Olson EN. A common progenitor at the heart of development. Cell. 2006;127:1101–4.
Chakraborty S, Combs MD, Yutzey KE. Transcriptional regulation of heart valve progenitor cells. Pediatr Cardiol. 2010;31:414–21.
Vaughan CJ, Basson CT. Molecular determinants of atrial and ventricular septal defects and patent ductus arteriosus. Am J Med Genet. 2000;97:304–9.
Thiene G, Anderson RH. The clinical morphology of tricuspid atresia. Atresia of the right atrioventricular valve. G Ital Cardiol. 1981;11:1845–59.
Hu P, Ji X, Yang C, et al. 22q11.2 microduplication in a family with recurrent fetal congenital heart disease. Eur J Med Genet. 2011;54:e433–6.
Alva C, David F, Hernandez M, et al. Tricuspid atresia associated with common arterial trunk and 22q11 chromosome deletion. Arch Cardiol Mex. 2003;73:271–4.
Miller GA, Paneth M, Lennox SC. Surgical management of pulmonary atresia with intact ventricular septum in first month of life. Br Heart J. 1973;35:554.
Trost D, Engels H, Bauriedel G, et al. Congenital cardiovascular malformations and chromosome microdeletions in 22q11.2. Dtsch Med Wochenschr. 1999;124:3–7.
Lizarraga MA, Mintegui S, Sanchez Echaniz J, et al. Heart malformations in trisomy 13 and trisomy 18. Rev Esp Cardiol. 1991;44:605–10.
Yu CW, Chen H, Baucum RW, et al. Terminal deletion of the long arm of chromosome 4. Report of a case of 46, XY, del(4)(q31) and review of 4q- syndrome. Ann Genet. 1981;24:158–61.
Brand A, Reifen RM, Armon Y, et al. Double mitral valve, complete atrioventricular canal, and tricuspid atresia in chromosomal 3P-syndrome. Pediatr Cardiol. 1987;8:55–6.
Wat MJ, Shchelochkov OA, Holder AM, et al. Chromosome 8p23.1 deletions as a cause of complex congenital heart defects and diaphragmatic hernia. Am J Med Genet A. 2009;149A:1661–77.
Wald RM, Tham EB, McCrindle BW, Goff DA, McAuliffe FM, Golding F, Jaeggi ET, Hornberger LK, Tworetzky W, Nield LE. Outcome after prenatal diagnosis of tricuspid atresia: a multicenter experience. Am Heart J. 2007;153(5):772–8. https://doi.org/10.1016/j.ahj.2007.02.030. PMID: 17452152
Morton SU, Quiat D, Seidman JG, Seidman CE. Genomic frontiers in congenital heart disease. Nat Rev Cardiol. 2021;19(1):26–42. https://doi.org/10.1038/s41569-021-00587-4. Epub ahead of print. PMID: 34272501
Hoggard, JA. Discovering pathogenic variants associated with tricuspid atresia through whole exome sequencing. Diss. 2019
Tevosian SG, Deconinck AE, Tanaka M, et al. FOG-2, a cofactor for GATA transcription factors, is essential for heart morphogenesis and development of coronary vessels from epicardium. Cell. 2000;101:729–39.
Lu JR, McKinsey TA, Xu H, et al. FOG-2, a heart- and brain-enriched cofactor for GATA transcription factors. Mol Cell Biol. 1999;19:4495–502.
Svensson EC, Huggins GS, Dardik FB, et al. A functionally conserved N-terminal domain of the friend of GATA-2 (FOG-2) protein represses GATA4-dependent transcription. J Biol Chem. 2000;275:20762–9.
Svensson EC, Huggins GS, Lin H, Clendenin C, Jiang F, Tufts R, Dardik FB, Leiden JM. A syndrome of tricuspid atresia in mice with a targeted mutation of the gene encoding fog-2. Nat Genet. 2000;25(3):353–6. https://doi.org/10.1038/77146. PMID: 10888889
Sarkozy A, Conti E, D’Agostino R, et al. ZFPM2/FOG2 and HEY2 genes analysis in nonsyndromic tricuspid atresia. Am J Med Genet A. 2005;133A:68–70.
Pizzuti A, Sarkozy A, Newton AL, et al. Mutations of ZFPM2/FOG2 gene in sporadic cases of tetralogy of Fallot. Hum Mutat. 2003;22:372–7.
Koibuchi N, Chin MT. CHF1/Hey2 plays a pivotal role in left ventricular maturation through suppression of ectopic atrial gene expression. Circ Res. 2007;100:850–5.
Fischer A, Schumacher N, Maier M, et al. The notch target genes Hey1 and Hey2 are required for embryonic vascular development. Genes Dev. 2004;18:901–11.
Reamon-Buettner SM, Borlak J. HEY2 mutations in malformed hearts. Hum Mutat. 2006;27:118.
Peng SL, Gerth AJ, Ranger AM, et al. NFATc1 and NFATc2 together control both T and B cell activation and differentiation. Immunity. 2001;14:13–20.
Zhou P, Sun LJ, Dotsch V, et al. Solution structure of the core NFATC1/DNA complex. Cell. 1998;92:687–96.
Ranger AM, Grusby MJ, Hodge MR, et al. The transcription factor NF-ATc is essential for cardiac valve formation. Nature. 1998;392:186–90.
Abdul-Sater Z, Yehya A, Beresian J, et al. Two heterozygous mutations in NFATC1 in a patient with tricuspid atresia. PLoS One. 2012;7:e49532.
Yehya A, Souki R, Bitar F, et al. Differential duplication of an intronic region in the NFATC1 gene in patients with congenital heart disease. Genome. 2006;49:1092–8.
Li B, Li T, Pu T, Liu C, Chen S, Sun K, Xu R. Genetic and functional analyses detect one pathological NFATC1 mutation in a Chinese tricuspid atresia family. Mol Genet Genomic Med. 2021;7:e1771. https://doi.org/10.1002/mgg3.1771. Epub ahead of print. PMID: 34363434
Bruneau BG, Nemer G, Schmitt JP, et al. A murine model of Holt-Oram syndrome defines roles of the T-box transcription factor Tbx5 in cardiogenesis and disease. Cell. 2001;106:709–21.
Stallmeyer B, Fenge H, Nowak-Gottl U, et al. Mutational spectrum in the cardiac transcription factor gene NKX2.5 (CSX) associated with congenital heart disease. Clin Genet. 2010;78:533–40.
Posch MG, Waldmuller S, Muller M, et al. Cardiac alpha-myosin (MYH6) is the predominant sarcomeric disease gene for familial atrial septal defects. PLoS One. 2011;6:e28872.
Granados-Riveron JT, Ghosh TK, Pope M, et al. Alpha-cardiac myosin heavy chain (MYH6) mutations affecting myofibril formation are associated with congenital heart defects. Hum Mol Genet. 2010;19:4007–16.
Ching YH, Ghosh TK, Cross SJ, et al. Mutation in myosin heavy chain 6 causes atrial septal defect. Nat Genet. 2005;37:423–8.
Nemer M, Horb ME. KLF family of transcriptional regulators in cardiomyocyte proliferation and differentiation. Cell Cycle. 2007;6(2):117–21. https://doi.org/10.4161/cc.6.2.3718. Epub 2007 Jan 13. PMID: 17245133
Li W, Li B, Li T, Zhang E, Wang Q, Chen S, Sun K. Identification and analysis of KLF13 variants in patients with congenital heart disease. BMC Med Genet. 2020;21(1):78. https://doi.org/10.1186/s12881-020-01009-x.
Darwich R, Li W, Yamak A, Komati H, Andelfinger G, Sun K, Nemer M. KLF13 is a genetic modifier of the Holt-Oram syndrome gene TBX5. Hum Mol Genet. 2017;26(5):942–54. https://doi.org/10.1093/hmg/ddx009. PMID: 28164238
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Sleiman, AK., Sadder, L., Nemer, G. (2024). Human Genetics of Tricuspid Atresia and Univentricular Heart. In: Rickert-Sperling, S., Kelly, R.G., Haas, N. (eds) Congenital Heart Diseases: The Broken Heart. Advances in Experimental Medicine and Biology, vol 1441. Springer, Cham. https://doi.org/10.1007/978-3-031-44087-8_54
Download citation
DOI: https://doi.org/10.1007/978-3-031-44087-8_54
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-44086-1
Online ISBN: 978-3-031-44087-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)