Document Detail

Genetic factors are important determinants of impaired growth after infant cardiac surgery.
MedLine Citation:
PMID:  20381076     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We sought to estimate the prevalence and identify the predictors of impaired growth after infant cardiac surgery.
METHODS: We performed a secondary analysis of a prospective study of the role of apolipoprotein E gene polymorphisms on neurodevelopment in young children after infant cardiac surgery. Prevalence estimates for growth velocity were derived by using anthropometric measures (weight and head circumference) obtained at birth and at 4 years of age. Genetic evaluation was also performed. Growth measure z scores were calculated by using World Health Organization Child Growth Standards. Growth velocity was evaluated by using 2 different techniques: first by clustering the children into one of 3 growth velocity subgroups based on z scores (impaired growth, difference < -0.5 standard deviation; stable growth, difference of -0.5 to 0.5 standard deviation; and improving growth, difference > 0.5 SD) and second by using continuous difference scores. Statistical analyses were conducted with a combination of proportional odds models for the ordered categories and simple linear regression for the continuous outcomes.
RESULTS: Three hundred nineteen full-term subjects had complete anthropometric measures for weight and head circumference at birth and 4 years. The cohort was 56% male. Genetic examinations were available for 97% (309/319) of the cohort (normal, 74%; definite or suspected genetic abnormality, 26%). Frequency counts for weight categories were as follows: impaired growth, 37%; stable growth, 31%; and improving growth, 32%. Frequency counts for head circumference categories were as follows: impaired growth, 39%; stable growth, 28%; and improving growth, 33%. The presence of a definite or suspected genetic syndrome (P = .04) was found to be a predictor of impaired growth for weight but not for head circumference. When growth z scores were used as continuous outcomes, the apolipoprotein E epsilon2 allele was found to be predictive of lower z scores for both weight (P = .02) and head circumference (P = .03).
CONCLUSIONS: Impaired growth for both weight and head circumference is common (both >30%) in this cohort of children after infant cardiac surgery. Both the apolipoprotein E epsilon2 allele and the presence of a definite or suspected genetic syndrome were associated with impaired weight growth velocity. The apolipoprotein E epsilon2 allele was also associated with impaired growth velocity for head circumference. Persistent poor growth might have long-term implications for the health and development of children with congenital heart defects.
Nancy Burnham; Richard F Ittenbach; Virginia A Stallings; Marsha Gerdes; Elaine Zackai; Judy Bernbaum; Robert R Clancy; J William Gaynor
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-04-09
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  140     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-08-12     Revised Date:  2014-09-18    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  144-9     Citation Subset:  AIM; IM    
Copyright Information:
2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Age Factors
Apolipoprotein E2 / genetics*
Body Weight / genetics*
Cardiac Surgical Procedures / adverse effects*
Child Development*
Child, Preschool
Gene Frequency
Genetic Predisposition to Disease
Growth Disorders / genetics*,  physiopathology,  prevention & control
Head / growth & development*
Heart Defects, Congenital / genetics,  physiopathology,  surgery*
Infant, Newborn
Linear Models
Odds Ratio
Polymorphism, Genetic*
Prospective Studies
Risk Assessment
Risk Factors
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Apolipoprotein E2

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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