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Background: The left ventricular outflow tract (LVOT) defects aortic valve stenosis (AVS), coarctation of the aorta (COA), and hypoplastic left heart syndrome (HLHS) represent an embryologically related group of congenital cardiovascular malformations. They are common and cause substantial morbidity and mortality. Prior evidence suggests a strong genetic component in their causation.
Methods: We selected NRG1, ERBB3, and ERBB4 of the epidermal growth factor receptor (EGFR) signaling pathway as candidate genes for investigation of association with LVOT defects based on the importance of this pathway in cardiac development and the phenotypes in knockout mouse models. Single nucleotide polymorphism (SNP) genotyping was performed on 343 affected case-parent trios of European ancestry.
Results: We identified a specific haplotype in intron 3 of ERBB4 that was positively associated with the combined LVOT defects phenotype (p=0.0005) and in each anatomic defect AVS, COA, and HLHS separately. Mutation screening of individuals with an LVOT defect failed to identify a coding sequence or splice site change in ERBB4. RT-PCR on lymphoblastoid cells from LVOT subjects did not show altered splice variant ratios among those homozygous for the associated haplotype.
Conclusion: These results suggest ERBB4 is associated with LVOT defects. Further replication will be required in separate cohorts to confirm the consistency of the observed association.
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http://dx.doi.org/10.1002/bdra.20764 | DOI Listing |
J Thorac Cardiovasc Surg
September 2025
Deparment of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address:
Objective: To evaluate the impact of CT planning on surgical myectomy outcomes in patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) and/or mid-cavity obstruction, by comparing these outcomes with those of conventional surgical myectomy.
Methods: This prospective cohort study included patients who underwent surgical septal myectomy for HCM with LVOT and/or mid-cavity obstruction between January 2019 and May 2024 at a single tertiary center. In the CT-planned myectomy group, an expert radiologist simulated the target myectomy site through a series of post-processing methods to plan the surgical approach, provide a surgeon's view that closely resembles the actual perspective in the operating room, and present the target myectomy volume.
BMJ Case Rep
August 2025
Department of Cardiology, National Hospital Organisation Kagoshima Medical Center, Kagoshima, Japan.
A woman in her 70 s presented with fatigue and dyspnoea during exertion. Six years ago, she had been implanted with a dual chamber pacemaker with the lead placement at the high septal site of the right ventricle. Echocardiography demonstrated the presence of the previously detected left ventricular septal bulge along with a newly observed systolic turbulent mosaic at left ventricular outflow tract (LVOT) and a systolic anterior motion (SAM) of the mitral valve.
View Article and Find Full Text PDFEur Heart J
August 2025
Department of Cardiothoracic Surgery, University Medical Centre Utrecht, 3584 CX, Heidelberglaan 100, Utrecht, The Netherlands.
Background And Aims: Outcomes after surgical myectomy in hypertrophic obstructive cardiomyopathy (HOCM) patients have not been investigated in a multicentre registry with detailed clinical data. Hence, the objectives of this multicentre Dutch study are to describe the 30-day clinical outcomes after surgical myectomy, and to assess factors associated with increased 30-day complication rates.
Methods: All HOCM patients (n = 335) who underwent surgery between 2012 and 2020 across 12 Dutch hospitals were analysed using data from the Netherlands Heart Registration.
EuroIntervention
August 2025
Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.
Background: The management of interventricular septal hypertrophy is an area of rapidly increasing interest, spurred by continued challenges with transcatheter mitral valve replacement (TMVR) and the management of obstructive hypertrophic cardiomyopathy (oHCM).
Aims: We sought to evaluate the reproducibility of septal scoring along the midline endocardium (SESAME), a novel transcatheter intervention designed to replicate surgical myotomy.
Methods: This single-centre, retrospective review included all patients who underwent the SESAME procedure at the University of Washington from January 2022 to September 2024.
J Ultrasound Med
August 2025
Department of Children and Women's Health, Osaka University, Osaka, Japan.
Background: Detection of conotruncal anomalies in the first trimester remains challenging. SlowflowHD, a Doppler modality with enhanced low-flow sensitivity, may improve visualization of cardiac outflow tracts.
Objective: To evaluate the utility of transabdominal SlowflowHD in detecting conotruncal congenital heart defects (CHDs) during routine first-trimester ultrasound screening.