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(Circulation. 1995;92:2803-2810.)
© 1995 American Heart Association, Inc.

Articles

Molecular Analysis of Nondisjunction in Down Syndrome Patients With and Without Atrioventricular Septal Defects

Mark M. Zittergruen, MD; Jeffrey C. Murray, MD; Ronald M. Lauer, MD; Trudy L. Burns, PhD; Val C. Sheffield, MD, PhD

From the Departments of Pediatrics and Preventive Medicine, University of Iowa Hospitals and Clinics, Iowa City.

Correspondence to Ronald M. Lauer, MD, Department of Pediatrics, Division of Pediatric Cardiology, 200 Hawkins Dr, University of Iowa Hospitals and Clinics, Iowa City, IA 52242.

Background Congenital heart disease is common in Down syndrome patients, with atrioventricular septal defects accounting for a majority of the abnormalities. The molecular mechanisms of meiotic nondisjunction resulting in Down syndrome were studied for associations with the presence of atrioventricular septal defects.

Methods and Results Twenty highly polymorphic chromosome 21 microsatellite markers were used to genotype two groups of patients (group 1: Down syndrome with atrioventricular septal defects, n=43; and group 2: Down syndrome without cardiac defects, n=51) to determine (1) the parental origin of the extra chromosome, (2) the stage of meiotic nondisjunction resulting in the trisomy, (3) the presence or absence of disomic homozygosity or heterozygosity, and (4) the degree of recombination in the nondisjoined chromosomes. The parental origin of the nondisjoined chromosome was maternal in 86.2% of the families, with no significant differences between groups. The most centromeric marker was nonreduced, indicating a meiosis I nondisjunction in 76.5% of maternally derived trisomies, and reduced, indicating a meiosis II nondisjunction in 76.9% of paternally derived trisomies, with no significant differences between groups. There were no significant differences in the proportion of reduced markers at any locus between groups. The distribution of the number of crossovers was significantly different between groups (²=14.12, P<.001), with less recombination observed in group 1.

Conclusions In Down syndrome patients, no association was found between the presence of an atrioventricular septal defect and the parent of origin, stage of meiotic nondisjunction, or disomic homozygosity or heterozygosity. A significant association was found between the presence of an atrioventricular septal defect and reduced frequency of recombination.

Key Words: Down syndrome • defects