Evidence map›Paper›PMID 35727948›Full record

ArticleCardiovascular research2023

Elucidation of the genetic causes of bicuspid aortic valve disease.

Jan Gehlen, Anja Stundl, Radoslaw Debiec, Federica Fontana, Markus Krane, Dinara Sharipova, Christopher P Nelson, Baravan Al-Kassou, Ann-Sophie Giel, Jan-Malte Sinning and 49 more

Open access · hybridAbstract read
In one paragraph

Article in Cardiovascular research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
7.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.

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  11. Chromosomal Location and Identification ofDiagnostics (Basel, Switzerland) · 2025
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  20. Valvulopathies and Genetics: Where are We?Reviews in cardiovascular medicine · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

59 authors at 20 institutions in 5 countries.

Jan GehlenInstitute of Human Genetics, University of Bonn and University Hospital Bonn, Bonn, Germany.
Anja StundlDepartment of Medicine II, Heart Center Bonn, University of Bonn and University Hospital Bonn, Bonn, Germany.ORCID 0000-0001-9634-5908
Radoslaw DebiecDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.ORCID 0000-0003-2292-467X
Federica FontanaInstitute of Biochemistry and Biology, Potsdam University, Potsdam, Germany.
Markus KraneDZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.ORCID 0000-0002-5466-9290
Dinara SharipovaInstitute of Biochemistry and Biology, Potsdam University, Potsdam, Germany.
Christopher P NelsonDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.ORCID 0000-0001-8025-2897
Baravan Al-KassouDepartment of Medicine II, Heart Center Bonn, University of Bonn and University Hospital Bonn, Bonn, Germany.
Ann-Sophie GielInstitute of Human Genetics, Philipps University of Marburg, Marburg, Germany.ORCID 0000-0003-2973-2099
Jan-Malte SinningDepartment of Medicine II, Heart Center Bonn, University of Bonn and University Hospital Bonn, Bonn, Germany.
Christopher M H BruengerInstitute of Human Genetics, Philipps University of Marburg, Marburg, Germany.ORCID 0000-0002-4182-7157
Carolin F ZelckInstitute of Human Genetics, Philipps University of Marburg, Marburg, Germany.
Laura L KoebbeInstitute of Human Genetics, Philipps University of Marburg, Marburg, Germany.ORCID 0000-0001-9962-0741
Peter S BraundDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Thomas R WebbDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.ORCID 0000-0001-5998-8226
Simon HetheringtonKettering General Hospital NHS Foundation Trust, Kettering, UK.
Stephan EnsmingerDepartment of Cardiac and Thoracic Vascular Surgery, University Heart Center Lübeck, University Hospital of Schleswig-Holstein, Lübeck, Germany.ORCID 0000-0002-9508-3261
Buntaro FujitaDepartment of Cardiac and Thoracic Vascular Surgery, University Heart Center Lübeck, University Hospital of Schleswig-Holstein, Lübeck, Germany.
Salah A MohamedDepartment of Cardiac and Thoracic Vascular Surgery, University Heart Center Lübeck, University Hospital of Schleswig-Holstein, Lübeck, Germany.ORCID 0000-0003-4365-8956
Malakh ShresthaDepartment of Adult and Pediatric Cardiothoracic Surgery, Vascular Surgery, Heart and Lung Transplantation, Hannover Medical School, Hannover, Germany.
Heike KruegerDepartment of Adult and Pediatric Cardiothoracic Surgery, Vascular Surgery, Heart and Lung Transplantation, Hannover Medical School, Hannover, Germany.
Matthias SiepeHeart Center Freiburg/Bad Krozingen, University Freiburg/Bad Krozingen, Freiburg, Germany.ORCID 0000-0003-3305-9343
Fabian Alexander KariHeart Center Freiburg/Bad Krozingen, University Freiburg/Bad Krozingen, Freiburg, Germany.ORCID 0000-0002-0985-9650
Peter NordbeckMedizinische Klinik und Poliklinik I, University Hospital Würzburg, Würzburg, Germany.ORCID 0000-0002-2560-4068
Larissa BuravezkyMedizinische Klinik und Poliklinik I, University Hospital Würzburg, Würzburg, Germany.
Malte KelmDepartment of Cardiology, Pneumology and Angiology, University Hospital Duesseldorf, Duesseldorf, Germany.ORCID 0000-0003-0060-1052
Verena VeulemansDepartment of Cardiology, Pneumology and Angiology, University Hospital Duesseldorf, Duesseldorf, Germany.ORCID 0000-0002-2744-2154
Matti AdamDepartment of Medicine III, Heart Center Cologne, University Hospital Cologne, Cologne, Germany.ORCID 0000-0002-6990-8135
Stephan BaldusDepartment of Medicine III, Heart Center Cologne, University Hospital Cologne, Cologne, Germany.
Karl-Ludwig LaugwitzKlinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.ORCID 0000-0003-4948-4846
Yannick HaasKlinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Matthias KarckDepartment of Cardiothoracic Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Uwe MehlhornDepartment of Cardiothoracic Surgery, Helios Klinik Karlsruhe, Karlsruhe, Germany.
Lars Oliver ConzelmannDepartment of Cardiothoracic Surgery, Helios Klinik Karlsruhe, Karlsruhe, Germany.
Ingo BreitenbachDepartment of Cardiothoracic Surgery and Vascular Surgery, Clinic of Braunschweig, Braunschweig, Germany.ORCID 0000-0002-5308-1655
Corinna LebherzDepartment of Medicine I, Cardiology/Angiology/Intensive Care, University Hospital Aachen, Aachen, Germany.
Paul UrbanskiDepartment of Cardiovascular Surgery, Cardiovascular Clinic, Rhön-Klinikum Campus Bad Neustadt, Neustadt, Germany.
Won-Keun KimDepartment of Cardiology, Heart Center, Kerckhoff Clinic, Bad Nauheim, Germany.ORCID 0000-0002-0799-7478
Joscha KandelsDepartment of Cardiology, University Hospital Leipzig, Leipzig, Germany.
David EllinghausInstitute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany.ORCID 0000-0002-4332-6110
Ulrike Nowak-GoettlDepartment of Clinical Chemistry, Thrombosis and Hemostasis Unit, University Hospital of Kiel and Lübeck, Kiel, Germany.
Per HoffmannInstitute of Human Genetics, University of Bonn and University Hospital Bonn, Bonn, Germany.
Felix WirthDivision of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany.
Stefanie DopplerDivision of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany.
Harald LahmDivision of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany.ORCID 0000-0002-4477-3406
Martina DreßenDivision of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, TUM School of Medicine, Technical University of Munich, Munich, Germany.ORCID 0000-0003-2200-6254
Moritz von ScheidtDZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.ORCID 0000-0001-7159-8271
Katharina KnollDZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
Thorsten KesslerDZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.ORCID 0000-0003-3326-1621
Christian HengstenbergDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-8284-2994
Heribert SchunkertDZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.ORCID 0000-0001-6428-3001
Georg NickenigDepartment of Medicine II, Heart Center Bonn, University of Bonn and University Hospital Bonn, Bonn, Germany.
Markus M NöthenInstitute of Human Genetics, University of Bonn and University Hospital Bonn, Bonn, Germany.
Aidan P BolgerNIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK.
Salim Abdelilah-SeyfriedInstitute of Biochemistry and Biology, Potsdam University, Potsdam, Germany.
Nilesh J SamaniDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Jeanette ErdmannDZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany.ORCID 0000-0002-4486-6231
Teresa TrenkwalderDZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
Johannes SchumacherInstitute of Human Genetics, University of Bonn and University Hospital Bonn, Bonn, Germany.ORCID 0000-0001-9217-6457
University of Bonn · DEGerman Centre for Cardiovascular Research · DEUniversity of Leicester · GBDeutsches Herzzentrum München · DEPhilipps University of Marburg · DEUniversity of Potsdam · DEUniversity Hospital Schleswig-Holstein · DEDüsseldorf University Hospital · DEKlinik für Herzchirurgie Karlsruhe · DEMedizinische Hochschule Hannover · DETUM Klinikum · DEUniversitäts-Herzzentrum Freiburg-Bad Krozingen · DEUniversitätsklinikum Würzburg · DEUniversity Hospital Cologne · DEHeidelberg University · DEKerckhoff Klinik · DEKettering General Hospital · GBKlinikum Braunschweig · DEMedical University of Vienna · ATRhön-Klinikum · DE

Funding

Medical Research Council MR/M012816/1
6 · The paper itself

Abstract

aimsThe present study aims to characterize the genetic risk architecture of bicuspid aortic valve (BAV) disease, the most common congenital heart defect. METHODS AND

resultsWe carried out a genome-wide association study (GWAS) including 2236 BAV patients and 11 604 controls. This led to the identification of a new risk locus for BAV on chromosome 3q29. The single nucleotide polymorphism rs2550262 was genome-wide significant BAV associated (P = 3.49 × 10-08) and was replicated in an independent case-control sample. The risk locus encodes a deleterious missense variant in MUC4 (p.Ala4821Ser), a gene that is involved in epithelial-to-mesenchymal transformation. Mechanistical studies in zebrafish revealed that loss of Muc4 led to a delay in cardiac valvular development suggesting that loss of MUC4 may also play a role in aortic valve malformation. The GWAS also confirmed previously reported BAV risk loci at PALMD (P = 3.97 × 10-16), GATA4 (P = 1.61 × 10-09), and TEX41 (P = 7.68 × 10-04). In addition, the genetic BAV architecture was examined beyond the single-marker level revealing that a substantial fraction of BAV heritability is polygenic and ∼20% of the observed heritability can be explained by our GWAS data. Furthermore, we used the largest human single-cell atlas for foetal gene expression and show that the transcriptome profile in endothelial cells is a major source contributing to BAV pathology.

conclusionOur study provides a deeper understanding of the genetic risk architecture of BAV formation on the single marker and polygenic level.

Indexed as

Bicuspid Aortic Valve DiseaseHeart Valve DiseasesAnimalsAortic ValveEndothelial CellsGenome-Wide Association StudyHumansZebrafishBicuspid aortic valveFoetal heart transcriptomeGWASSNP-based heritabilityZebrafish

Identifiers

PMID35727948
PMCPMC10153415
OpenAlexW4283213717

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.