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Abnormal Microarray, Clinical Outcomes, and Surgical Risk Scores in Young Children with Cardiac Disease

Pediatric Cardiology volume 42, pages 1785–1791 (2021)Cite this article

Abstract

The clinical implications of abnormal chromosomal microarray (CMA) remain unclear for children less than 1 year of age with critical heart disease. Our objective was to determine whether abnormal CMA was related to surgical severity scores or to pre-determined clinical outcomes, including cardiac arrest. Retrospective review of children under 1 year of age admitted to a pediatric cardiac intensive care unit from December, 2014 to September, 2017. Associations between CMA result and cardiac arrest, syndromic abnormalities, and extracardiac anomalies were evaluated. A simple and multivariable logistic regression model was used to analyze associations between STAT mortality category and CMA result. The overall prevalence of abnormal microarray was 48/168 (29%), with peak prevalence in AV septal defects and left-sided obstructive lesions. There was no statistical association between surgical severity scores and abnormal CMA (STAT 1/2 vs. 3+, odds ratio 0.56, p = 0.196). Abnormal CMA was associated with a higher prevalence of cardiac arrest (5/48 abnormal CMA vs. 2/120 normal CMA, p = 0.02). Abnormal CMA was associated with a higher frequency of syndromic abnormalities (18/48 abnormal CMA vs. 13/120 normal CMA, p < 0.001). There was a high prevalence of abnormal CMA findings in the pediatric cardiac population less than 1 year of age (29%), associated with cardiac arrest, but not associated with surgical risk score. The absence of a standardized protocol for ordering a CMA in the setting of congenital heart disease results in a highly variable prevalence data.

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Funding

Research reported in this publication was supported, in part, by the National Institutes of Health, National Heart, Lung and Blood Institute, grant number K23HL130554, the American Heart Association Mentored Clinical and Population Research Award (Dallas, TX). REDCap access was provided by Northwestern University Clinical and Translational Sciences Institute, funded in part by NIH UL1TR001422.

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Affiliations

  1. Division of Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 21, Chicago, IL, 60611, USA

    Kelsey McAfee, Sara Cherny, Catherine A. Collins & Gregory Webster

  2. Department of Preventive Medicine (Biostatistics), Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Will T. Rosenow & Lauren C. Balmert

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  1. Kelsey McAfee
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  2. Will T. Rosenow
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  3. Sara Cherny
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  4. Catherine A. Collins
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  5. Lauren C. Balmert
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  6. Gregory Webster
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Contributions

KM: Conceptualization, Data curation, Investigation, Visualization, Writing-Original draft preparation WTR: Formal analysis, Software SC: Writing—Review & Editing, Validation CAC: Writing—Review & Editing LCB: Formal analysis, Software GW: Funding Acquisition, Methodology, Supervision, Writing—Review & Editing.

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Correspondence to Gregory Webster.

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McAfee, K., Rosenow, W.T., Cherny, S. et al. Abnormal Microarray, Clinical Outcomes, and Surgical Risk Scores in Young Children with Cardiac Disease. Pediatr Cardiol 42, 1785–1791 (2021). https://doi.org/10.1007/s00246-021-02664-4

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  • DOI: https://doi.org/10.1007/s00246-021-02664-4

Keywords

  • Pediatric
  • Congenital heart disease
  • Chromosomal microarray
  • Cardiac arrest
  • Surgical risk score