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Albuquerque FND, Brandão AA, Silva DA, Rocha RM, Bittencourt MI, Sales ALF, Spineti PPDM, Duque GS, Azevedo LRDS, Pozzan R, Tura BR, Albuquerque DCD. Ser49Gly Beta1-Adrenergic Receptor Genetic Polymorphism as a Death Predictor in Brazilian Patients with Heart Failure. Arq Bras Cardiol 2020; 114:616-624. [PMID: 32491001 DOI: 10.36660/abc.20190187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 06/05/2019] [Indexed: 01/08/2023] Open
Abstract
Background The role of Ser49Gly beta1-adrenergic receptor genetic polymorphism (ADBR1-GP-Ser49Gly) as a predictor of death in heart failure (HF) is not established for the Brazilian population. Objectives To evaluate the association between ADBR1-GP-Ser49Gly and clinical outcomes in individuals with HF with reduced ejection fraction. Methods Secondary analysis of medical records of 178 patients and genotypes of GPRβ1-Ser49Gly variants, classified as Ser-Ser, Ser-Gly and Gly-Gly. To evaluate their association with clinical outcome. A significance level of 5% was adopted. Results Cohort means were: clinical follow-up 6.7 years, age 63.5 years, 64.6% of men and 55.1% of whites. HF etiologies were predominantly ischemic (31.5%), idiopathic (23.6%) and hypertensive (15.7%). The genetic profile was distributed as follows: 122 Ser-Ser (68.5%), 52 Ser-Gly (28.7%) and 5 Gly-Gly (2.8%). There was a significant association between these genotypes and mean NYHA functional class at the end of follow-up (p = 0.014) with Gly-Gly being associated with less advanced NYHA. In relation to the clinical outcomes, there was a significant association (p = 0.026) between mortality and GPRβ1-Ser49Gly: the number of deaths in patients with Ser-Gly (12) or Gly-Gly (1) was lower than in those with Ser-Ser (54). The Gly allele had an independent protective effect maintained after multivariate analysis and was associated with a reduction of 63% in the risk of death (p = 0.03; Odds Ratio 0.37 - CI 0.15-0.91). Conclusion The presence of β1-AR-GP Gly-Gly was associated with better clinical outcome evaluated by NYHA functional class and was a predictor of lower risk of mortality, regardless of other factors, in a 6.7-year of follow-up. (Arq Bras Cardiol. 2020; 114(4):613-615).
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Affiliation(s)
- Felipe Neves de Albuquerque
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.,Instituto de Biologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | | | | | | | | | | | | | | | - Roberto Pozzan
- Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Huang J, Li C, Song Y, Fan X, You L, Tan L, Xiao L, Li Q, Ruan G, Hu S, Cui W, Li Z, Ni L, Chen C, Woo AYH, Xiao RP, Wang DW. ADRB2 polymorphism Arg16Gly modifies the natural outcome of heart failure and dictates therapeutic response to β-blockers in patients with heart failure. Cell Discov 2018; 4:57. [PMID: 30374408 PMCID: PMC6198009 DOI: 10.1038/s41421-018-0058-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/18/2018] [Accepted: 08/20/2018] [Indexed: 12/18/2022] Open
Abstract
We sought to investigate the association of single nucleotide polymorphisms (SNPs) of the genes involved in βAR signaling with the response of patients to βAR blockers. A total of 2403 hospitalized patients with chronic heart failure (HF) were enrolled in a multicenter observational study as the first cohort and followed up for a mean period of 20 months. Genes for β1AR, β2AR, and the major cardiac G-protein-coupled receptor kinases (GRKs) GRK2 and GRK5 were analyzed to identify SNPs, and patients were stratified according to genotypes. A second independent cohort enrolling 919 patients with chronic HF was applied to validate the observed associations. The signaling properties of the key identified SNPs were assessed in vitro. Our data showed that HF patients harboring the Gly16 allele in the gene for β2AR (ADRB2) had an increased risk of the composite end point relative to patients who were homozygous for Arg16. Notably, these patients showed a beneficial response to βAR-blocker treatment in a G allele-dose-dependent manner, whereas Arg16 homozygotes had no response to βAR-blocker therapy. This Arg16Gly genotype-dependent heterogeneity in clinical outcomes of HF was successfully validated in the second independent population. Besides, the in vitro experiments revealed that G allele carriers were defective in β2AR-coupled inhibitory adenylate cyclase g (Gi) protein signaling.
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Affiliation(s)
- Jin Huang
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiologic Disorders, 430030 Wuhan, China
| | - Chenze Li
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiologic Disorders, 430030 Wuhan, China
| | - Ying Song
- 3Institute of Molecular Medicine, Peking-Tsinghua Centre for Life Sciences, Peking University, 100871 Beijing, China
| | - Xiaohan Fan
- 4Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China
| | - Ling You
- 5Division of Cardiology, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, China
| | - Lun Tan
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China
| | - Lei Xiao
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China
| | - Qing Li
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China
| | - Guoran Ruan
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China
| | - Senlin Hu
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China
| | - Wei Cui
- 5Division of Cardiology, The Second Hospital of Hebei Medical University, 050000 Shijiazhuang, China
| | - Zongzhe Li
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China
| | - Li Ni
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China
| | - Chen Chen
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiologic Disorders, 430030 Wuhan, China
| | - Anthony Yiu-Ho Woo
- 3Institute of Molecular Medicine, Peking-Tsinghua Centre for Life Sciences, Peking University, 100871 Beijing, China.,6Department of Pharmacology, School of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, 110016 Shenyang, China
| | - Rui-Ping Xiao
- 3Institute of Molecular Medicine, Peking-Tsinghua Centre for Life Sciences, Peking University, 100871 Beijing, China
| | - Dao Wen Wang
- 1Division of Cardiology, Departments of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 430030 Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiologic Disorders, 430030 Wuhan, China
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3
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Dhein S, Dohmen PM, Sauer M, Tews J, Weickmann J, Funkat AK, Misfeld M, Borger MA, Mohr FW. Effects of β-Adrenoceptor and Catechol-O-Methyl-Transferase (COMT) Polymorphism on Postoperative Outcome in Cardiac Surgery Patients. Med Sci Monit Basic Res 2017; 23:223-233. [PMID: 28522796 PMCID: PMC5445899 DOI: 10.12659/msmbr.902820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND There is a long-standing debate about the role of beta-adrenoceptor polymorphisms in the cardiovascular system. We wanted to elucidate whether β1-adrenoceptor-polymorphisms affects the postoperative catecholamine consumption and the length of intermediate care unit stay in patients undergoing cardiac surgery, and whether this might be enhanced or attenuated by catechol-O-methyl-transferase (COMT) polymorphism. MATERIAL AND METHODS We included 116 patients (63±1.2 years; 34% females; 81±1 kg) undergoing cardiac surgery. We assessed Arg389Gly and Ser49Gly-β1-adrenoceptor (B1AR) polymorphism together with Val158Met-COMT polymorphism by real-time PCR using fluorescence resonance energy transfer (PCR-FRET). The preoperative risk was assessed by EuroSCORE. In addition, we measured the endogenous preoperative epinephrine and norepinephrine plasma concentrations using an electrochemical HPLC method. RESULTS 84.6% were homozygous for Ser49Ser, 52.1% homozygous for Arg389Arg B1AR, and 32.5% for Val158Val-COMT, while 15.4% showed Ser49Gly B1AR, 38.5% Arg389Gly-B1AR, and 35.6% Val158Met-COMT. We found that the Gly49-variant, the Gly389-variant, and the Val158-COMT-variant were associated with higher postoperative norepinephrine consumption. All patients carrying the Val158-COMT allele exhibited higher preoperative norepinephrine concentrations. Moreover, we found that both β1-adrenoceptor polymorphisms were associated with a longer stay in hospital, which was modulated by the COMT polymorphism. CONCLUSIONS These data show that the β1-adrenoceptor polymorphisms, together with the COMT polymorphism, affect norepinephrine consumption and stay in hospital in a situation of enhanced cardiovascular stress, reflected here by the postoperative period after cardiac surgery. Moreover, we conclude that patients with the Val158-COMT genotype exhibit higher endogenous resting plasma norepinephrine levels.
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Affiliation(s)
- Stefan Dhein
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
| | - Pascal M Dohmen
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany.,Department of Cardiac Surgery, European University Oldenburg-Groningen, Oldenburg, Germany.,Department of Cardiothoracic Surgery, Faculty of Health Science, University of the Free State, Bloemfontein, South Africa
| | - Matthias Sauer
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
| | - Julia Tews
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
| | - Johannes Weickmann
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
| | - Anne-Kathrin Funkat
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
| | - Martin Misfeld
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
| | - Michael A Borger
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
| | - Friedrich W Mohr
- Department of Cardiac Surgery, Heart Center Leipzig University of Leipzig, Leipzig, Germany
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Abstract
PURPOSE OF REVIEW Heart failure (HF) is a disease state with great heterogeneity, which complicates the therapeutic process. Identifying more precise HF phenotypes will allow for the development of more targeted therapies and improvement in patient outcomes. This review explores the future for precision medicine in HF treatment. RECENT FINDINGS Rather than a continuous disease spectrum with a uniform pathogenesis, HF has phenotypes with different underlying pathophysiologic features. The challenge is to establish clinical phenotypic characterizations to direct therapy. Phenomapping, a process of using machine learning algorithms applied to clinical data sets, has been used to identify phenotypically distinct and clinically meaningful HF groups. As powerful technologies extend our knowledge, future analyses may be able to compile more comprehensive phenotypic profiles using genetic, epigenetic, proteomic, and metabolomic measurements. Identifying clinical characterizations of particular HF patients that would be uniquely or disproportionately responsive to a specific treatment would allow for more direct selection of optimal therapy, reduce trial-and-error prescribing, and help avoid adverse drug reactions.
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Métrich M, Mehmeti F, Feliciano H, Martin D, Regamey J, Tozzi P, Meyer P, Hullin R. Adrenergic Receptor Polymorphism and Maximal Exercise Capacity after Orthotopic Heart Transplantation. PLoS One 2016; 11:e0163475. [PMID: 27669015 PMCID: PMC5036840 DOI: 10.1371/journal.pone.0163475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/10/2016] [Indexed: 11/18/2022] Open
Abstract
Background Maximal exercise capacity after heart transplantion (HTx) is reduced to the 50–70% level of healthy controls when assessed by cardiopulmonary exercise testing (CPET) despite of normal left ventricular function of the donor heart. This study investigates the role of donor heart β1 and β2- adrenergic receptor (AR) polymorphisms for maximal exercise capacity after orthotopic HTx. Methods CPET measured peak VO2 as outcome parameter for maximal exercise in HTx recipients ≥9 months and ≤4 years post-transplant (n = 41; mean peak VO2: 57±15% of predicted value). Donor hearts were genotyped for polymorphisms of the β1-AR (Ser49Gly, Arg389Gly) and the β2-AR (Arg16Gly, Gln27Glu). Circumferential shortening of the left ventricle was measured using magnetic resonance based CSPAMM tagging. Results Peak VO2 was higher in donor hearts expressing the β1-Ser49Ser alleles when compared with β1-Gly49 carriers (60±15% vs. 47±10% of the predicted value; p = 0.015), and by trend in cardiac allografts with the β1-AR Gly389Gly vs. β1-Arg389 (61±15% vs. 54±14%, p = 0.093). Peak VO2 was highest for the haplotype Ser49Ser-Gly389, and decreased progressively for Ser49Ser-Arg389Arg > 49Gly-389Gly > 49Gly-Arg389Arg (adjusted R2 = 0.56, p = 0.003). Peak VO2 was not different for the tested β2-AR polymorphisms. Independent predictors of peak VO2 (adjusted R2 = 0.55) were β1-AR Ser49Gly SNP (p = 0.005), heart rate increase (p = 0.016), and peak systolic blood pressure (p = 0.031). Left ventricular (LV) motion kinetics as measured by cardiac MRI CSPAMM tagging at rest was not different between carriers and non-carriers of the β1-AR Gly49allele. Conclusion Similar LV cardiac motion kinetics at rest in donor hearts carrying either β1-AR Gly49 or β1-Ser49Ser variant suggests exercise-induced desensitization and down-regulation of the β1-AR Gly49 variant as relevant pathomechanism for reduced peak VO2 in β1-AR Gly49 carriers.
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Affiliation(s)
- Mélanie Métrich
- Cardiology, Cardiovascular Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Fortesa Mehmeti
- Cardiology, University Hospital Geneva, University of Geneva, Geneva, Switzerland
| | - Helene Feliciano
- Department of Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - David Martin
- Cardiology, Cardiovascular Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Julien Regamey
- Cardiology, Cardiovascular Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Piergiorgio Tozzi
- Cardiac Surgery, Cardiovascular Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Philippe Meyer
- Cardiology, University Hospital Geneva, University of Geneva, Geneva, Switzerland
| | - Roger Hullin
- Cardiology, Cardiovascular Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- * E-mail:
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6
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Zanolla L, Guarise P, Tomasi L, Vassanelli C, Cicorella N, Zanini R, Guarrera S, Fiorito G, Matullo G. Association between Beta1 -Adrenergic Receptor Polymorphism and Risk of ICD Shock in Heart Failure Patients. Pacing Clin Electrophysiol 2016; 39:557-64. [PMID: 27027728 DOI: 10.1111/pace.12860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 01/27/2016] [Accepted: 03/20/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sympathetic activation in heart failure patients favors the development of ventricular arrhythmias, thus leading to an increased risk of sudden cardiac death. β1 - and β2 -adrenergic receptor polymorphisms have been linked to the risk of sudden death. Implantable cardioverter-defibrillators (ICD) are implanted in a large percentage of heart failure patients, and beyond preventing sudden cardiac death they provide a continuous monitoring of major ventricular arrhythmias and of their own interventions. We investigated whether functionally relevant β1 - and β2 -adrenergic receptor polymorphisms are associated with risk of ICD shocks, as evidenced in ICD memory. METHODS 311 patients with systolic heart failure were enrolled, and number and timing of shocks in ICD memory were recorded. Four selected polymorphisms were determined: β1 -adrenergic receptor polymorphisms Ser(49) Gly and Arg(389) Gly and β2 -adrenergic receptor polymorphisms Arg(16) Gly and Gln(27) Glu. RESULTS Only Ser(49) Gly was significantly correlated with time free from ICD shocks, both considering time to the first event in a Cox model (hazard ratio 2.117), and modeling repeated events with the Andersen-Gill method (hazard ratio 2.088). Gly allele carriers had a higher probability of ICD shock. The relationship remained significant even after adjusting for ejection fraction and beta-blocker dosage (hazard ratio 1.910). CONCLUSIONS Data from our study suggest that the β adrenoreceptor Gly 49 allele of the β1 -adrenergic receptor Ser(49) Gly polymorphisms may increase the risk of ICD shock in patients with heart failure, independent of beta-blocker dosage.
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Affiliation(s)
- Luisa Zanolla
- Department of Medicine, Cardiology Division, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Paola Guarise
- Department of Medicine, Cardiology Division, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Luca Tomasi
- Department of Medicine, Cardiology Division, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Corrado Vassanelli
- Department of Medicine, Cardiology Division, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Nicola Cicorella
- Struttura Complessa di Cardiologia, Dipartimento Cardio-Toraco, Vascolare Azienda Ospedaliera "Carlo Poma,", Mantova, Italy
| | - Roberto Zanini
- Struttura Complessa di Cardiologia, Dipartimento Cardio-Toraco, Vascolare Azienda Ospedaliera "Carlo Poma,", Mantova, Italy
| | - Simonetta Guarrera
- Department Medical Sciences, University of Torino, Torino, Italy.,Human Genetics Foundation (HuGeF), Torino, Italy
| | - Giovanni Fiorito
- Department Medical Sciences, University of Torino, Torino, Italy.,Human Genetics Foundation (HuGeF), Torino, Italy
| | - Giuseppe Matullo
- Department Medical Sciences, University of Torino, Torino, Italy.,Human Genetics Foundation (HuGeF), Torino, Italy
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7
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Guo M, Guo G, Ji X. Genetic polymorphisms associated with heart failure: A literature review. J Int Med Res 2016; 44:15-29. [PMID: 26769713 PMCID: PMC5536573 DOI: 10.1177/0300060515604755] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 08/03/2015] [Indexed: 12/22/2022] Open
Abstract
Objective To review possible associations reported between genetic variants and the risk, therapeutic response and prognosis of heart failure. Methods Electronic databases (PubMed, Web of Science and CNKI) were systematically searched for relevant papers, published between January 1995 and February 2015. Results Eighty-two articles covering 29 genes and 39 polymorphisms were identified. Conclusion Genetic association studies of heart failure have been highly controversial. There may be interaction or synergism of several genetic variants that together result in the ultimate pathological phenotype for heart failure.
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Affiliation(s)
- Mengqi Guo
- Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Qilu Hospital, Shandong University, Jinan, China
| | - Guanlun Guo
- Hubei Key Laboratory of Advanced Technology of Automotive Components, School of Automotive Engineering, Wuhan University of Technology, Wuhan, China
| | - Xiaoping Ji
- Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Qilu Hospital, Shandong University, Jinan, China
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8
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Anwar MS, Iskandar MZ, Parry HM, Doney AS, Palmer CN, Lang CC. The future of pharmacogenetics in the treatment of heart failure. Pharmacogenomics 2015; 16:1817-27. [DOI: 10.2217/pgs.15.120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Heart failure is a common disease with high levels of morbidity and mortality. Current treatment comprises β-blockers, ACE inhibitors, aldosterone antagonists and diuretics. Variation in clinical response seen in patients begs the question of whether there is a pharmacogenetic component yet to be identified. To date, the genes most studied involve the β-1, β-2, α-2 adrenergic receptors and the renin-angiotensin-aldosterone pathway, mainly focusing on SNPs. However results have been inconsistent. Genome-wide association studies and next-generation sequencing are seen as alternative approaches to discovering genetic variations influencing drug response. Hopefully future research will lay the foundations for genotype-led drug management in these patients with the ultimate aim of improving their clinical outcome.
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Affiliation(s)
- Mohamed Subhan Anwar
- Division of Cardiovascular & Diabetes Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - Muhammad Zaid Iskandar
- Division of Cardiovascular & Diabetes Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - Helen M Parry
- Department of Pharmacogenetics & Pharmacogenomics, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - Alex S Doney
- Department of Pharmacogenetics & Pharmacogenomics, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - Colin N Palmer
- Division of Cardiovascular & Diabetes Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - Chim C Lang
- Division of Cardiovascular & Diabetes Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
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9
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Parry HM, Doney AS, Palmer CN, Lang CC. State of Play of Pharmacogenetics and Personalized Medicine in Heart Failure. Cardiovasc Ther 2013; 31:315-22. [DOI: 10.1111/1755-5922.12030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Helen M. Parry
- Division of Cardiovascular and Diabetes Medicine; Ninewells Hospital and Medical School; University of Dundee; Dundee UK
| | - Alex S.F. Doney
- Division of Cardiovascular and Diabetes Medicine; Ninewells Hospital and Medical School; University of Dundee; Dundee UK
| | - Colin N.A. Palmer
- Department of Pharmacogenetics and Pharmacogenomics; Ninewells Hospital and Medical School; University of Dundee; Dundee UK
| | - Chim C. Lang
- Division of Cardiovascular and Diabetes Medicine; Ninewells Hospital and Medical School; University of Dundee; Dundee UK
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10
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Filigheddu F. Genetic prediction of heart failure incidence, prognosis and beta-blocker response. Mol Diagn Ther 2013; 17:205-19. [PMID: 23592012 DOI: 10.1007/s40291-013-0035-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Heart failure (HF) is a widespread syndrome due to left ventricular dysfunction with high mortality, morbidity and health-care costs. Beta-blockers, together with diuretics and ACE-inhibitors or angiotensin receptor blockers, are a cornerstone of HF therapy, as they reduce mortality and morbidity. Nevertheless, their efficacy varies among patients, and genetics is likely to be one of the modifying factors. In this article, literature on the role of candidate genes on the development of HF, its prognosis and pharmacogenomics of β-blockers in patients with HF is reviewed. The available findings do not support, at the present time, a role for genetic tests in the treatment of HF. More large-scale genome-wide studies with adequate methodology and statistical analysis are required before considering genetic tailoring of HF therapy in patients with systolic HF.
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Affiliation(s)
- Fabiana Filigheddu
- Department of Clinical and Experimental Medicine, University of Sassari, Viale S.Pietro 8, 07100 Sassari, Italy.
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11
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Liu WN, Fu KL, Gao HY, Shang YY, Wang ZH, Jiang GH, Zhang Y, Zhang W, Zhong M. β1 adrenergic receptor polymorphisms and heart failure: a meta-analysis on susceptibility, response to β-blocker therapy and prognosis. PLoS One 2012; 7:e37659. [PMID: 22815685 PMCID: PMC3398943 DOI: 10.1371/journal.pone.0037659] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 04/22/2012] [Indexed: 12/20/2022] Open
Abstract
Aims The risk stratification of patients for heart failure (HF) remains a challenge, as well as the anticipation of the response to β-blocker therapy. Since the pivotal role of β1 adrenergic receptor (β1-AR) in HF, many publications have studied the associations between the β1-AR polymorphisms (Ser49Gly and Arg389Gly) and HF, with inconsistent results. Thus, we performed a meta-analysis of studies to evaluate the impact of β1-AR polymorphisms on susceptibility to HF, the response to β-blocker therapy and the prognosis of HF. Methods and Results Electronic databases were systematically searched before August 2011. We extracted data sets and performed meta-analysis with standardized methods. A total of 27 studies met our inclusion criteria. It was found that in East Asians, the Gly389 allele and Gly389 homozygotes significantly increased the HF risk, while the Gly389 allele and Gly389 homozygotes trended to decrease the risk of HF in whites. With the similar reduction of heart rate, overall, the Arg389 homozygotes showed a better response to β-blocker therapy. Furthermore, the Arg389 homozygotes were significantly associated with better LVEF improvement in East Asians and a mixed population. And in white people, the Arg389 homozygotes made a greater LVESd/v improvement and trended to be associated with better LVEDd/v improvement. However, the prognosis of Arg389 homozygotes HF patients was similar to those with Gly389 carriers. The Ser49Gly polymorphism did not impact the risk or prognosis of HF. Conclusion Based on our meta-analysis, the Gly389 allele and Gly389 homozygotes were risk factors in East Asians while trending to protect whites against HF. Furthermore, Arg389 homozygote is significantly associated with a favorable response to β-blocker treatment in HF patients. However, neither of the two polymorphisms is an independent predictor of the prognosis of HF.
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Affiliation(s)
- Wen-Nan Liu
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Kai-Li Fu
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Hai-Yang Gao
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Yuan-Yuan Shang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Zhi-Hao Wang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Gui-Hua Jiang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Yun Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Wei Zhang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
| | - Ming Zhong
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Ji’nan, People’s Republic of China
- Department of Cardiology, Qilu Hospital of Shandong University, Ji’nan, People’s Republic of China
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