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Gene predisposes infants to neurologic injury after heart surgery

Children with heart conditions who require surgery as infants may be more vulnerable to neurologic problems if they have a particular variety of a gene.

Researchers from the Cardiac Center and other divisions of The Children's Hospital of Philadelphia found that children carrying the epsilon2 version (APOE ε2) of the apolipoprotein E gene were significantly more likely to have worse neurodevelopmental outcomes at age one, compared to children who also underwent surgery but did not have APOE ε2. APOE ε2 occurs in approximately 8 percent of the population.

The APOE ε2 gene variant may decrease the ability of neurons to repair themselves following open heart surgery, with the result that children score lower in developmental evaluations of psychomotor skills. The study was published in the December issue of the Journal of Thoracic and Cardiovascular Surgery.

"As surgical and medical advances have dramatically increased survival of children with heart defects in recent years, we have turned our attention to the adverse neurodevelopmental outcomes in some survivors," said cardiothoracic surgeon J. William Gaynor, M.D., the leader of the study. "Even among children with the same heart defect receiving the same surgeries, there is considerable variation in developmental outcome. This was one of the first studies to investigate the role of gene variants in influencing neurologic injury in children with congenital heart disease."

The research team evaluated 244 children at age one who had undergone surgery to repair a congenital heart defect at less than six months of age. All the children were patients at the Cardiac Center at The Children's Hospital of Philadelphia.

Evaluators who were blinded to each child's genotype assessed the children using the Bayley Scales of Infant Development. Within those measurements, children with APOE ε2 had significantly lower scores in the Psychomotor Development
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Contact: John Ascenzi
Ascenzi@email.chop.edu
267-426-6055
Children's Hospital of Philadelphia
26-Jan-2004


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