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Published in: Journal of Genetic Counseling 6/2014

01-12-2014 | Original Research

Provision of Cardiovascular Genetic Counseling Services: Current Practice and Future Directions

Authors: Allyson E. Somers, Stephanie M. Ware, Kathleen Collins, John L. Jefferies, Hua He, Erin M. Miller

Published in: Journal of Genetic Counseling | Issue 6/2014

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Abstract

Cardiovascular genetic counseling has emerged as a specialty critical to the care of patients with heritable cardiovascular disease. Current strategies to meet the growing demand are not clear. We sought to characterize practice patterns of cardiac genetic counseling by developing a novel survey distributed to the National Society of Genetic Counselors (NSGC) Listserv to assess clinical practice, cardiovascular training, and education. Descriptive statistics were used to summarize clinical practice; Fisher’s exact test and the Cochran-Armitage trend test were used to compare the practice of cardiovascular genetic counselors (CVGCs) to those who did not identify cardiology as a specialty (non-CVGCs). A total of 153 individuals completed the survey. Of the 105 participants who reported seeing a cardiac genetics patient, 42 (40 %) identified themselves as a CVGC. The most common conditions for which genetic counseling was provided were hypertrophic cardiomyopathy (HCM) (71 % of participants), dilated cardiomyopathy (DCM) (61 %), long QT syndrome (LQTS) (56 %), and genetic syndromes with cardiovascular disease (55 %). CVGCs were significantly more confident than non-CVGCs in providing genetic counseling for seven cardiovascular diseases (2.3 × 10−6 ≤ p ≤ 0.021). Eighty-six percent of genetic counselors sought additional education related to cardiovascular genetics and listed online courses as the most desirable method of learning. These data suggest a growing interest in cardiovascular genetic counseling and need for additional training resources among the NSGC membership.
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Literature
go back to reference Ackerman, M. J., Priori, S. G., Willems, S., Berul, C., Brugada, R., Calkins, H., et al. (2011). HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). Heart Rhythm, 8(8), 1308–1339 [Consensus Development Conference].PubMedCrossRef Ackerman, M. J., Priori, S. G., Willems, S., Berul, C., Brugada, R., Calkins, H., et al. (2011). HRS/EHRA expert consensus statement on the state of genetic testing for the channelopathies and cardiomyopathies this document was developed as a partnership between the Heart Rhythm Society (HRS) and the European Heart Rhythm Association (EHRA). Heart Rhythm, 8(8), 1308–1339 [Consensus Development Conference].PubMedCrossRef
go back to reference American Society of Clinical Oncology. (2003). American Society of Clinical Oncology policy statement update: genetic testing for cancer susceptibility. Journal of Clinical Oncology, 21(12), 2397–2406.CrossRef American Society of Clinical Oncology. (2003). American Society of Clinical Oncology policy statement update: genetic testing for cancer susceptibility. Journal of Clinical Oncology, 21(12), 2397–2406.CrossRef
go back to reference Arnold, K. M., & Self, Z. B. (2012). Genetic screening and counseling: family medicine obstetrics. Primary Care, 39(1), 55–70 [Review].PubMedCrossRef Arnold, K. M., & Self, Z. B. (2012). Genetic screening and counseling: family medicine obstetrics. Primary Care, 39(1), 55–70 [Review].PubMedCrossRef
go back to reference Ashley, E. A., Hershberger, R. E., Caleshu, C., Ellinor, P. T., Garcia, J. G., Herrington, D. M., et al. (2012). Genetics and cardiovascular disease: a policy statement from the American heart association. Circulation, 126(1), 142–157.PubMedCentralPubMedCrossRef Ashley, E. A., Hershberger, R. E., Caleshu, C., Ellinor, P. T., Garcia, J. G., Herrington, D. M., et al. (2012). Genetics and cardiovascular disease: a policy statement from the American heart association. Circulation, 126(1), 142–157.PubMedCentralPubMedCrossRef
go back to reference Bassett, A. S., McDonald-McGinn, D. M., Devriendt, K., Digilio, M. C., Goldenberg, P., Habel, A., et al. (2011). Practical guidelines for managing patients with 22q11.2 deletion syndrome. Journal of Pediatrics, 159(2), 332–339 [Case Reports].PubMedCentralPubMedCrossRef Bassett, A. S., McDonald-McGinn, D. M., Devriendt, K., Digilio, M. C., Goldenberg, P., Habel, A., et al. (2011). Practical guidelines for managing patients with 22q11.2 deletion syndrome. Journal of Pediatrics, 159(2), 332–339 [Case Reports].PubMedCentralPubMedCrossRef
go back to reference Bull, M. J. (2011). Health supervision for children with down syndrome. Pediatrics, 128(2), 393–406.PubMedCrossRef Bull, M. J. (2011). Health supervision for children with down syndrome. Pediatrics, 128(2), 393–406.PubMedCrossRef
go back to reference Demo, E. M., Skrzynia, C., & Baxter, S. (2009). Genetic counseling and testing for hypertrophic cardiomyopathy: the pediatric perspective. Journal of Cardiovascular Translational Research, 2(4), 500–507.PubMedCrossRef Demo, E. M., Skrzynia, C., & Baxter, S. (2009). Genetic counseling and testing for hypertrophic cardiomyopathy: the pediatric perspective. Journal of Cardiovascular Translational Research, 2(4), 500–507.PubMedCrossRef
go back to reference den Haan, A. D., Tan, B. Y., Zikusoka, M. N., Llado, L. I., Jain, R., Daly, A., et al. (2009). Comprehensive desmosome mutation analysis in north americans with arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation. Cardiovascular Genetics, 2(5), 428–435 [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t].PubMedCentralCrossRef den Haan, A. D., Tan, B. Y., Zikusoka, M. N., Llado, L. I., Jain, R., Daly, A., et al. (2009). Comprehensive desmosome mutation analysis in north americans with arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation. Cardiovascular Genetics, 2(5), 428–435 [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t].PubMedCentralCrossRef
go back to reference Dunn, K. E., Caleshu, C., Cirino, A. L., Ho, C. Y., & Ashley, E. A. (2013). A clinical approach to inherited hypertrophy: the use of family history in diagnosis, risk assessment, and management. Circulation. Cardiovascular Genetics, 6(1), 118–131.PubMedCentralPubMedCrossRef Dunn, K. E., Caleshu, C., Cirino, A. L., Ho, C. Y., & Ashley, E. A. (2013). A clinical approach to inherited hypertrophy: the use of family history in diagnosis, risk assessment, and management. Circulation. Cardiovascular Genetics, 6(1), 118–131.PubMedCentralPubMedCrossRef
go back to reference Fowler, S. J., Napolitano, C., & Priori, S. G. (2009). The genetics of cardiomyopathy: genotyping and genetic counseling. Current Treatment Options Cardiovascular Medicine, 11(6), 433–446.CrossRef Fowler, S. J., Napolitano, C., & Priori, S. G. (2009). The genetics of cardiomyopathy: genotyping and genetic counseling. Current Treatment Options Cardiovascular Medicine, 11(6), 433–446.CrossRef
go back to reference Hemminki, K., Sundquist, J., & Lorenzo Bermejo, J. (2008). Familial risks for cancer as the basis for evidence-based clinical referral and counseling. The Oncologist, 13(3), 239–247 [Research Support, Non-U.S. Gov’t].PubMedCrossRef Hemminki, K., Sundquist, J., & Lorenzo Bermejo, J. (2008). Familial risks for cancer as the basis for evidence-based clinical referral and counseling. The Oncologist, 13(3), 239–247 [Research Support, Non-U.S. Gov’t].PubMedCrossRef
go back to reference Hershberger, R. E., Cowan, J., Morales, A., & Siegfried, J. D. (2009a). Progress with genetic cardiomyopathies: screening, counseling, and testing in dilated, hypertrophic, and arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation. Heart Failure, 2(3), 253–261 [Research Support, N.I.H., Extramural Review].PubMedCentralPubMedCrossRef Hershberger, R. E., Cowan, J., Morales, A., & Siegfried, J. D. (2009a). Progress with genetic cardiomyopathies: screening, counseling, and testing in dilated, hypertrophic, and arrhythmogenic right ventricular dysplasia/cardiomyopathy. Circulation. Heart Failure, 2(3), 253–261 [Research Support, N.I.H., Extramural Review].PubMedCentralPubMedCrossRef
go back to reference Hershberger, R. E., Lindenfeld, J., Mestroni, L., Seidman, C. E., Taylor, M. R., & Towbin, J. A. (2009b). Genetic evaluation of cardiomyopathy–a heart failure society of America practice guideline. Journal of Cardiac Failure, 15(2), 83–97 [Practice Guideline].PubMedCrossRef Hershberger, R. E., Lindenfeld, J., Mestroni, L., Seidman, C. E., Taylor, M. R., & Towbin, J. A. (2009b). Genetic evaluation of cardiomyopathy–a heart failure society of America practice guideline. Journal of Cardiac Failure, 15(2), 83–97 [Practice Guideline].PubMedCrossRef
go back to reference Hiratzka, L. F., Bakris, G. L., Beckman, J. A., Bersin, R. M., Carr, V. F., Casey, D. E., Jr., et al. (2010). A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Catheterization and Cardiovascular Interventions, 76(2), E43–E86.PubMedCrossRef Hiratzka, L. F., Bakris, G. L., Beckman, J. A., Bersin, R. M., Carr, V. F., Casey, D. E., Jr., et al. (2010). A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Catheterization and Cardiovascular Interventions, 76(2), E43–E86.PubMedCrossRef
go back to reference Hofman, N., Tan, H. L., Alders, M., van Langen, I. M., & Wilde, A. A. (2010). Active cascade screening in primary inherited arrhythmia syndromes: does it lead to prophylactic treatment? Journal of the American College of Cardiology, 55(23), 2570–2576 [Research Support, Non-U.S. Gov’t].PubMedCrossRef Hofman, N., Tan, H. L., Alders, M., van Langen, I. M., & Wilde, A. A. (2010). Active cascade screening in primary inherited arrhythmia syndromes: does it lead to prophylactic treatment? Journal of the American College of Cardiology, 55(23), 2570–2576 [Research Support, Non-U.S. Gov’t].PubMedCrossRef
go back to reference Ingles, J., Yeates, L., & Semsarian, C. (2011). The emerging role of the cardiac genetic counselor. Heart Rhythm, 8(12), 1958–1962.PubMedCrossRef Ingles, J., Yeates, L., & Semsarian, C. (2011). The emerging role of the cardiac genetic counselor. Heart Rhythm, 8(12), 1958–1962.PubMedCrossRef
go back to reference Keane, M. G., & Pyeritz, R. E. (2008). Medical management of Marfan syndrome. Circulation, 117(21), 2802–2813 [Review].PubMedCrossRef Keane, M. G., & Pyeritz, R. E. (2008). Medical management of Marfan syndrome. Circulation, 117(21), 2802–2813 [Review].PubMedCrossRef
go back to reference Kuzmik, G. A., Sang, A. X., & Elefteriades, J. A. (2012). Natural history of thoracic aortic aneurysms. Journal of Vascular Surgery, 56(2), 565–571.PubMedCrossRef Kuzmik, G. A., Sang, A. X., & Elefteriades, J. A. (2012). Natural history of thoracic aortic aneurysms. Journal of Vascular Surgery, 56(2), 565–571.PubMedCrossRef
go back to reference Marino, B., & Digilio, M. C. (2000). Congenital heart disease and genetic syndromes: specific correlation between cardiac phenotype and genotype. Cardiovascular Pathology, 9(6), 303–315 [Review].PubMedCrossRef Marino, B., & Digilio, M. C. (2000). Congenital heart disease and genetic syndromes: specific correlation between cardiac phenotype and genotype. Cardiovascular Pathology, 9(6), 303–315 [Review].PubMedCrossRef
go back to reference Michels, M., Hoedemaekers, Y. M., Kofflard, M. J., Frohn-Mulder, I., Dooijes, D., Majoor-Krakauer, D., et al. (2007). Familial screening and genetic counselling in hypertrophic cardiomyopathy: the Rotterdam experience. Netherlands Heart Journal, 15(5), 184–190.PubMedCentralPubMedCrossRef Michels, M., Hoedemaekers, Y. M., Kofflard, M. J., Frohn-Mulder, I., Dooijes, D., Majoor-Krakauer, D., et al. (2007). Familial screening and genetic counselling in hypertrophic cardiomyopathy: the Rotterdam experience. Netherlands Heart Journal, 15(5), 184–190.PubMedCentralPubMedCrossRef
go back to reference Nabel, E. G. (2003). Cardiovascular disease. New England Journal of Medicine, 349(1), 60–72 [Review].PubMedCrossRef Nabel, E. G. (2003). Cardiovascular disease. New England Journal of Medicine, 349(1), 60–72 [Review].PubMedCrossRef
go back to reference Pierpont, M. E., Basson, C. T., Benson, D. W., Jr., Gelb, B. D., Giglia, T. M., Goldmuntz, E., et al. (2007). Genetic basis for congenital heart defects: current knowledge: a scientific statement from the American Heart Association Congenital Cardiac Defects Committee, Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation, 115(23), 3015–3038 [Review].PubMedCrossRef Pierpont, M. E., Basson, C. T., Benson, D. W., Jr., Gelb, B. D., Giglia, T. M., Goldmuntz, E., et al. (2007). Genetic basis for congenital heart defects: current knowledge: a scientific statement from the American Heart Association Congenital Cardiac Defects Committee, Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation, 115(23), 3015–3038 [Review].PubMedCrossRef
go back to reference Resource document for curriculum development in cancer genetics education. American Society of Clinical Oncology. (1997). Journal of Clinical Oncology, 15(5), 2157–2169. Resource document for curriculum development in cancer genetics education. American Society of Clinical Oncology. (1997). Journal of Clinical Oncology, 15(5), 2157–2169.
go back to reference Resta, R., Biesecker, B. B., Bennett, R. L., Blum, S., Hahn, S. E., Strecker, M. N., et al. (2006). A new definition of genetic counseling: national society of genetic counselors’ task force report. Journal of Genetic Counseling, 15(2), 77–83.PubMedCrossRef Resta, R., Biesecker, B. B., Bennett, R. L., Blum, S., Hahn, S. E., Strecker, M. N., et al. (2006). A new definition of genetic counseling: national society of genetic counselors’ task force report. Journal of Genetic Counseling, 15(2), 77–83.PubMedCrossRef
go back to reference Schwartz, P. J., Stramba-Badiale, M., Crotti, L., Pedrazzini, M., Besana, A., Bosi, G., et al. (2009). Prevalence of the congenital long-QT syndrome. Circulation, 120(18), 1761–1767 [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t].PubMedCentralPubMedCrossRef Schwartz, P. J., Stramba-Badiale, M., Crotti, L., Pedrazzini, M., Besana, A., Bosi, G., et al. (2009). Prevalence of the congenital long-QT syndrome. Circulation, 120(18), 1761–1767 [Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov’t].PubMedCentralPubMedCrossRef
go back to reference Skrzynia, C., Demo, E. M., & Baxter, S. M. (2009). Genetic counseling and testing for hypertrophic cardiomyopathy: an adult perspective. Journal of Cardiovascular Translational Research, 2(4), 493–499 [Case Reports Review].PubMedCrossRef Skrzynia, C., Demo, E. M., & Baxter, S. M. (2009). Genetic counseling and testing for hypertrophic cardiomyopathy: an adult perspective. Journal of Cardiovascular Translational Research, 2(4), 493–499 [Case Reports Review].PubMedCrossRef
go back to reference Sturm, A. C., & Hershberger, R. E. (2013). Genetic testing in cardiovascular medicine: current landscape and future horizons. Current Opinion in Cardiology, 28(3), 317–325 [Review].PubMed Sturm, A. C., & Hershberger, R. E. (2013). Genetic testing in cardiovascular medicine: current landscape and future horizons. Current Opinion in Cardiology, 28(3), 317–325 [Review].PubMed
go back to reference van Langen, I. M., Birnie, E., Schuurman, E., Tan, H. L., Hofman, N., Bonsel, G. J., et al. (2005). Preferences of cardiologists and clinical geneticists for the future organization of genetic care in hypertrophic cardiomyopathy: a survey. Clinical Genetics, 68(4), 360–368 [Comparative Study Research Support, Non-U.S. Gov’t].PubMedCrossRef van Langen, I. M., Birnie, E., Schuurman, E., Tan, H. L., Hofman, N., Bonsel, G. J., et al. (2005). Preferences of cardiologists and clinical geneticists for the future organization of genetic care in hypertrophic cardiomyopathy: a survey. Clinical Genetics, 68(4), 360–368 [Comparative Study Research Support, Non-U.S. Gov’t].PubMedCrossRef
Metadata
Title
Provision of Cardiovascular Genetic Counseling Services: Current Practice and Future Directions
Authors
Allyson E. Somers
Stephanie M. Ware
Kathleen Collins
John L. Jefferies
Hua He
Erin M. Miller
Publication date
01-12-2014
Publisher
Springer US
Published in
Journal of Genetic Counseling / Issue 6/2014
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI
https://doi.org/10.1007/s10897-014-9719-2

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