Abstract
Introduction: "From Heart to Sole” is a study exploring a non-invasive, low cost screening method for congenital heart disease (CHD).
Methods: This pilot study explores identification of a specific crease on the sole of the foot as a marker for early detection of CHD in newborns. A Qualitrics survey was developed and distributed on social media platforms (Facebook, LinkedIn, etc) and the Adult Congenital Heart Association “Studies Recruiting Subjects” webpage. Participants were queried whether they have been diagnosed with a CHD and what type, whether they have the specific crease on either foot, and about the presence other health issues including a genetic syndrome. This study has been approved by the Institutional Review Board at The College of New Jersey and the Medical Advisory Board Research Committee of the Adult Congenital Heart Association.
Results: Study participants were all over the age of 18 years, with a total of 53 responses, 69.8% female (n = 37), nine people did not disclose their gender(17%). The majority of the respondents were Caucasian(n=36 or 67.9%). Nine surveys were not fully completed. Thirty-two people reported a CHD diagnosis while 21 respondents did not answer this item. Approximately 40% of respondents reported having a diagnosis of Tetralogy of Fallot(TOF) (n=20, 62.5%). A Fisher exact test was conducted using SPSS IBM (version 29). A statistically significant association was found between having any CHD diagnosis and the presence of a crease on any foot (p value = 0.15). All participants who reported presence of a foot crease except for one with a chromosomal syndrome also reported a diagnosis of a CHD. No association was found between a TOF diagnosis and presence of a crease on any foot (p value = 0.235). No association was found between Caucasian race and presence of a crease on any foot (p value= 1). No association was found between gender and presence of a crease on any foot (p value = 0.214). Associations between other CHD diagnoses, other racial groups, and presence of a crease could not be analyzed due to small sample size.
Conclusions: A statistically significant association was identified between having a CHD and the presence of a crease on any foot. Further research is needed to identify whether there is an association between presence of the crease and a specific CHD and to evaluate the effectiveness of evaluating for the presence of a crease on either foot as a screening for CHD in newborns.
Notes
References:
1. Assenza, G. E., Krieger, E. V., Baumgartner, H., Cupido, B., Dimopoulos, K., Louis, C., Lubert, A. M., Stout, K. K., Valente, A. M., Zeppenfeld, K., & Opotowsky, A. R. (2021). AHA/ACC vs ESC guidelines for management of adults with congenital heart disease: JACC guideline comparison. Journal of the American College of Cardiology, 78(19), 1904–1918. https://doi.org/10.1016/j.jacc.2021.09.010.
2. Ataman, A. D., Vatanoğlu-Lutz, E. E., & Yildirim, G. (2012). Medicine in stamps: History of Down syndrome through philately. Journal of the Turkish German Gynecological Association, 13(4), 267–269. https://doi.org/10.5152/jtgga.2012.43.
Bhanu, B. (1973). Simian crease in man: Some methodological considerations. Journal of Human Evolution, 2(2), 153-160. https://doi.org/10.1016/0047-2484(73)90062-6.
3. Centers for Disease Control and Prevention. (2024, May 15). Congenital heart
defects. United States Department of Health and Human Services. www.cdc.gov/heart-defects.
4. Congenital Heart Public Health Consortium (2024, August 12). Congenital Heart Defect Fact Sheets. American Academy of Pediatrics. https://www.aap.org/en/patient-care/congenital-heart-defects/congenital-heart-defect-fact-sheets/#:~:text=Congenital%20heart%20defects%20(CHDs)%20are,or%20in%20the%20wrong%20place.
5.De Lestrange, M. T. (1969). The transverse crease in Europe: Index and comparative study of different samples cited in the literature. American Journal of Physical Anthropology, 30(2), 173–182. https://doi.org/10.1002/ajpa.1330300203.
6.Embong, N. H., Soh, Y. C., Ming, L. C., & Wong, T. W. (2015). Revisiting reflexology: Concept, evidence, current practice, and practitioner training. Journal of Traditional and Complementary Medicine, 5(4), 197–206. https://doi.org/10.1016/j.jtcme.2015.08.008.
7.Gatzoulis, M., Swan, A. L., Therrien, J. & Pantley, G. A. (2010). Adult congenital heart disease: A practical guide. 2nd ed. Blackwell.
8.Hom, L. A., & Martin, G. R. (2020). Newborn critical congenital heart disease screening using pulse oximetry: Value and unique challenges in developing regions. International Journal of Neonatal Screening, 6(3), 74. https://doi.org/10.3390/ijns6030074.
9.Ntiloudi, D., Gatzoulis, M.A., Alexandra, A., Karvounis, H., & Giannakoulas, G. (2021). Adult congenital heart disease: Looking back, moving forward. International Journal of Cardiology Congenital Heart Disease, 2. https://doilorg/10.1016/j.jijcchd.2020.1000076.
10. Oster, M. E., Aucott, S. W., Glidewell, J., Hackell, J., Kochilas, L., Martin, G. R., Phillippi, J., Pinto, N. M., Saarinen, A., Sontag, M., & Kemper, A. R. (2016). Lessons learned from newborn screening for critical congenital heart defects. Pediatrics, 137(5), Article 20154573. https://doi.org/10.1542/peds.2015-4573
11.Rohit, M., & Rajan, P. (2020). Approach to cyanotic congenital heart disease in children. Indian Journal of Pediatrics, 87(5), 372–380. https://doi.org/10.1007/s12098-020-03274-3.
12.Singh, Y., & Chen, S. E. (2022). Impact of pulse oximetry screening to detect congenital heart defects: 5 years' experience in a UK regional neonatal unit. European Journal of Pediatrics, 181(2), 813–821. https://doi.org/10.1007/s00431-021-04275-w.
13.Whatley, J., Perkins, J., & Samuel, C. (2022). Reflexology: Exploring the mechanism of action. Complementary Therapies in Clinical Practice, 48, Article 101606. https://doi.org/10.1016/j.ctcp.2022.101606.
Sigma Membership
Xi, Delta Nu
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Pilot/Exploratory Study
Keywords:
Primary Care, Acute Care, Congenital Heart Disease, Newborns
Recommended Citation
Jakubowski, Tami L.; Mann, Simranjot; Cartnick, Emma; Curtis, Sarah; Kenner, Carole; and Boykova, Marina, "Early Detection of Congenital Heart Disease: From Heart to Sole" (2025). International Nursing Research Congress (INRC). 193.
https://www.sigmarepository.org/inrc/2025/presentations_2025/193
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Early Detection of Congenital Heart Disease: From Heart to Sole
Seattle, Washington, USA
Introduction: "From Heart to Sole” is a study exploring a non-invasive, low cost screening method for congenital heart disease (CHD).
Methods: This pilot study explores identification of a specific crease on the sole of the foot as a marker for early detection of CHD in newborns. A Qualitrics survey was developed and distributed on social media platforms (Facebook, LinkedIn, etc) and the Adult Congenital Heart Association “Studies Recruiting Subjects” webpage. Participants were queried whether they have been diagnosed with a CHD and what type, whether they have the specific crease on either foot, and about the presence other health issues including a genetic syndrome. This study has been approved by the Institutional Review Board at The College of New Jersey and the Medical Advisory Board Research Committee of the Adult Congenital Heart Association.
Results: Study participants were all over the age of 18 years, with a total of 53 responses, 69.8% female (n = 37), nine people did not disclose their gender(17%). The majority of the respondents were Caucasian(n=36 or 67.9%). Nine surveys were not fully completed. Thirty-two people reported a CHD diagnosis while 21 respondents did not answer this item. Approximately 40% of respondents reported having a diagnosis of Tetralogy of Fallot(TOF) (n=20, 62.5%). A Fisher exact test was conducted using SPSS IBM (version 29). A statistically significant association was found between having any CHD diagnosis and the presence of a crease on any foot (p value = 0.15). All participants who reported presence of a foot crease except for one with a chromosomal syndrome also reported a diagnosis of a CHD. No association was found between a TOF diagnosis and presence of a crease on any foot (p value = 0.235). No association was found between Caucasian race and presence of a crease on any foot (p value= 1). No association was found between gender and presence of a crease on any foot (p value = 0.214). Associations between other CHD diagnoses, other racial groups, and presence of a crease could not be analyzed due to small sample size.
Conclusions: A statistically significant association was identified between having a CHD and the presence of a crease on any foot. Further research is needed to identify whether there is an association between presence of the crease and a specific CHD and to evaluate the effectiveness of evaluating for the presence of a crease on either foot as a screening for CHD in newborns.
Description
The "From Heart to Sole" pilot study explores the significance of a specific crease on the sole of the foot as a marker for CHD. A statistically significant association was found between having any CHD diagnosis and the presence of a crease on any foot (p value = 0.15). Further research is needed to determine clinical usefulness of the specific foot crease as a screening tool for CHD.