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a Department of Pediatrics, University of Rome "La Sapienza", Viale Regina Elena 324, Rome 00161, Italy
b Department of Medical Genetics, Bambino Gesù Hospital, Piazza S. Onofrio, 4, Rome 00165, Italy
(Email: bruno.marino{at}uniroma1.it; claudia.saffirio{at}gmail.com).
The interesting article by Drury and colleagues [1] reports a patient with primum atrial septal defect with partial left pericardial defect and discusses the mechanisms of pericardial defect development.
The embryological mechanisms of pericardial development were correctly reported in this article in agreement with the recent literature [2]. However, the genetic causes of normal and abnormal development of the pericardium are still largely unknown.
A recent article reports the impaired mesenchymal cell function in GATA4 gene mutant mice leading to diaphragmatic hernia and heart, pericardial and lung defects [3]. GATA4 is a very important gene for the development of the heart, which is involved in the pathogenesis of familial atrial septal defect [4, 5], and it is the candidate gene for deletion 8p syndrome [6].
Among the heart defect associated with deletion 8p syndrome, we reported a patient with ostium secundum atrial septal defect with partial pericardial defect [7]; it is interesting to note the high frequency of atrial septal defect in this syndrome [7] and in patients with nonsyndromic pericardial defects [1]. In conclusion, we suggest that GATA4 gene should be considered a candidate gene for pericardial defects in humans based on the report in mice [3].
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N. E. Drury and S. R. Large Reply Ann. Thorac. Surg., December 1, 2007; 84(6): 2137 - 2137. [Full Text] [PDF] |
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