Gene Poses Neurologic Risk to Infants after Heart Surgery

A study has found that children with heart conditions requiring surgery are more at risk of neurologic problems if they have a particular version of a gene. The finding was reported in the December 2003 issue of the Journal of Thoracic and Cardiovascular Surgery.

Researchers evaluated 244 children at age one who had undergone surgery to repair a congenital heart defect at less than six months of age. Specifically, they found that children carrying the epsilon2 version (APOE 2) of the apolipoprotein E gene were significantly more apt to have worse neurodevelopmental outcomes at age one, compared to children who also had surgery but lacked that version of the gene. The epsilon2 version occurs in about 8% of the population. This variant may decrease the ability of neurons to repair themselves following open heart surgery, so that children score lower in developmental evaluations of psychomotor skills. The link between the gene variant and lower neurodevelopmental scores was consistent, even after researchers controlled for variables such as gestational age, age at surgery, socioeconomic status, type of cardiac defect, and surgical techniques.

"The adverse effect on neurodevelopment that we found at one year of age does not necessarily predict long-term outcome for these children,” cautioned study leader J. William Gaynor, M.D., a cardiothoracic surgeon at The Children's Hospital of Philadelphia (PA, USA). "Children will need to be evaluated as they reach school age to determine whether the APOE 2 gene is a risk factor for worse long-term outcome.”




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