Contribution of rare inherited and de novo variants in 2,871 congenital heart disease probands
Jin SC., Homsy J., Zaidi S., Lu Q., Morton S., Depalma SR., Zeng X., Qi H., Chang W., Sierant MC., Hung WC., Haider S., Zhang J., Knight J., Bjornson RD., Castaldi C., Tikhonoa IR., Bilguvar K., Mane SM., Sanders SJ., Mital S., Russell MW., Gaynor JW., Deanfield J., Giardini A., Porter GA., Srivastava D., Lo CW., Shen Y., Watkins WS., Yandell M., Yost HJ., Tristani-Firouzi M., Newburger JW., Roberts AE., Kim R., Zhao H., Kaltman JR., Goldmuntz E., Chung WK., Seidman JG., Gelb BD., Seidman CE., Lifton RP., Brueckner M.
Congenital heart disease (CHD) is the leading cause of mortality from birth defects. Here, exome sequencing of a single cohort of 2,871 CHD probands, including 2,645 parent-offspring trios, implicated rare inherited mutations in 1.8%, including a recessive founder mutation in GDF1 accounting for ∼5% of severe CHD in Ashkenazim, recessive genotypes in MYH6 accounting for ∼11% of Shone complex, and dominant FLT4 mutations accounting for 2.3% of Tetralogy of Fallot. De novo mutations (DNMs) accounted for 8% of cases, including ∼3% of isolated CHD patients and ∼28% with both neurodevelopmental and extra-cardiac congenital anomalies. Seven genes surpassed thresholds for genome-wide significance, and 12 genes not previously implicated in CHD had >70% probability of being disease related. DNMs in ∼440 genes were inferred to contribute to CHD. Striking overlap between genes with damaging DNMs in probands with CHD and autism was also found.