Dermatoglyphics in congenital heart disease.

SUMMARY Dermatoglyphics form in utero during early gestation and may be influenced by genetic or environmental factors operating at that time. Since cardiac embryogenesis also occurs during early gestation, an analysis of dermatoglyphics in congenital heart disease (CHD) miight reveal some types which are associated with aberrant dermato-glyphics. Ten dermatoglyphic traits were analyzed in 225 individuals with CHD proved, in most instances, by extensive radiologic studies and at surgery. These traits were compared with dermatoglyphics in 200 normal control subjects. The analysis revealed that the atd angle was significantly increased in CHD. Except for endocardial fibroelastosis and atrioventricular canal, all subtypes of CHD had a wider atd angle than controls. In ventricular septal defect, patent ductus arteriosus, tetralogy of Fallot, and multiple cardiac defects, the increase was statistically significant. The present study confirms previous reports that the atd angle may be increased in CHD. Additional Indexing Words: atd angle Mongolism Axial triradius Cardiac embryology MOST congenital cardiovascular anomalies have their genesis early in gestation during embryogenesis of the individual organs or organ systems. In the majority of cases of congenital heart disease (CHD), no specific etiologic basis has been established. However, a number of such anomalies are clearly of genetic origin resulting either from single gene disorders or gross chromosomal aberrations.' Specific environmental influences have also been implicated as causative factors .2'3 McKusick' stated that polygenic inheritance is an important genetic mechanism in the common forms of congenital heart disease. Other authors have speculated that a large percentage of cardiovascular anomalies are From the Epidemiology and Genetics Unit, the result of interplay between both genetic and environmental factors with the relative importance of each factor varying according to the specific lesion involved.2' 4 Dermatoglyphic configurations formed by the epidermal ridges on fingers, palms, and soles begin to develop during the sixth to seventh week of fetal life. Development is completed by the fourth month of gestation and thereafter the patterns remain the same.5 There is wide agreement that the mechanism of inheritance of many dermatoglyphic features also conforms to a polygenic system with each gene contributing a small additive effect. Examples of these dermatoglyphic traits are the transversality of the ridges on the palm,6' 7 the a-b ridge count,8' 9 and the atd angle.10 Other features such as the calcar pattems' appear to be influenced by a single gene. Information as to the loci that influence dermatoglyphics is still speculative, …