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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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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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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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Atrial natriuretic peptide gene variants and circulating levels: implications in cardiovascular diseases. Clin Sci (Lond) 2014; 127:1-13. [PMID: 24611929 DOI: 10.1042/cs20130427] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
ANP (atrial natriuretic peptide), discovered 30 years ago in rat cardiac atria, has been extensively investigated with regard to physiology, pathophysiology, cardiovascular disease therapeutics and molecular genetic aspects. Besides its diuretic, natriuretic and vasorelaxant effects, novel properties of this hormone have been described. Thus anti-hypertrophic, anti-fibrotic, anti-proliferative and anti-inflammatory actions suggest that ANP contributes not only to haemodynamic homoeostasis and adjustments, but has also a role in cardiovascular remodelling. Circulating ANP levels represent a valuable biomarker in cardiovascular diseases. ANP structure is highly conserved among species, indicating a key role in cardiovascular health. Thus an abnormal ANP structure may contribute to an increased risk of disease due to altered functions at either the vascular or cardiac level. Among others, the 2238T>C exon 3 variant has been associated with endothelial cell damage and dysfunction and with an increased risk of acute cardiovascular events, a frameshift mutation within exon 3 has been related to increased risk of atrial fibrillation, and ANP gene variants have been linked to increased risk of hypertension in different ethnic groups. On the other hand, the rs5068 variant, falling within the 3' UTR and associated with higher circulating ANP levels, has been shown to have a beneficial cardioprotective and metabolic effect. Dissecting out the disease mechanisms dependent on specific ANP molecular variants may reveal information useful in the clinical setting for diagnostic, prognostic and therapeutic purposes. Furthermore, insights from molecular genetic analysis of ANP may well integrate advancing knowledge on the role of ANP as a significant biomarker in patients affected by cardiovascular diseases.
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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
- * E-mail:
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Clerico A, Giannoni A, Vittorini S, Passino C. Thirty years of the heart as an endocrine organ: physiological role and clinical utility of cardiac natriuretic hormones. Am J Physiol Heart Circ Physiol 2011; 301:H12-20. [DOI: 10.1152/ajpheart.00226.2011] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Thirty years ago, De Bold et al. ( 20 ) reported that atrial extracts contain some biologically active peptides, which promote a rapid and massive diuresis and natriuresis when injected in rats. It is now clear that the heart also exerts an endocrine function and in this way plays a key role in the regulation of cardiovascular and renal systems. The aim of this review is to discuss some recent insights and still-debated findings regarding the cardiac natriuretic hormones (CNHs) produced and secreted by cardiomyocytes (i.e., atrial natriuretic peptide and B-type natriuretic peptide). The functional status of the CNH system depends not only on the production/secretion of CNHs by cardiomyocytes but also on both the peripheral activation of circulating inactive precursor of natriuretic hormones and the transduction of the hormone signal by specific receptors. In this review, we will discuss the data supporting the hypothesis that the production and secretion of CNHs is the result of a complex integration among mechanical, chemical, hemodynamic, humoral, ischemic, and inflammatory inputs. The cross talk among endocrine function, adipose tissue, and sex steroid hormones will be discussed more in detail, considering the clinically relevant relationships linking together cardiovascular risk, sex, and body fat development and distribution. Finally, we will review the pathophysiological role and the clinical relevance of both peripheral maturation of the precursor of B-type natriuretic peptides and hormone signal transduction .
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Affiliation(s)
- Aldo Clerico
- Scuola Superiore Sant'Anna, Fondazione del Consiglio Nazionale delle Ricerche e della Regione Toscana, Gabriele Monasterio, Pisa, Italy
| | - Alberto Giannoni
- Scuola Superiore Sant'Anna, Fondazione del Consiglio Nazionale delle Ricerche e della Regione Toscana, Gabriele Monasterio, Pisa, Italy
| | - Simona Vittorini
- Scuola Superiore Sant'Anna, Fondazione del Consiglio Nazionale delle Ricerche e della Regione Toscana, Gabriele Monasterio, Pisa, Italy
| | - Claudio Passino
- Scuola Superiore Sant'Anna, Fondazione del Consiglio Nazionale delle Ricerche e della Regione Toscana, Gabriele Monasterio, Pisa, Italy
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Jin B, Ge-Shang QZ, Li Y, Shen W, Shi HM, Ni HC. A meta-analysis of β1-adrenergic receptor gene polymorphisms in idiopathic dilated cardiomyopathy. Mol Biol Rep 2011; 39:563-7. [PMID: 21553224 DOI: 10.1007/s11033-011-0771-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 04/27/2011] [Indexed: 11/27/2022]
Abstract
Published data on the association between β1-adrenergic receptor gene polymorphisms and idiopathic dilated cardiomyopathy (IDCM) risk are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. A total of 12 case-control studies including 2642 cases and 3136 controls provided data on the association between β1-adrenergic receptor gene polymorphisms and susceptibility to IDCM. Overall, no significantly elevated risk was associated with Arg389Gly polymorphisms for all genetic models. In the subgroup analysis by ethnicity, no statistically increased risk was found for Gly389Gly versus Arg389Arg (OR 0.73; 95% CI 0.54-0.99; Ph=0.35) and Gly389Gly versus Arg389Arg+Arg389Gly (OR 0.75; 95% CI 0.55-1.01; Ph=0.52) among Europeans. Meanwhile, significantly increased risk was found among Asians based on the relatively small sample size. Further, significantly elevated IDCM risk was associated with Ser49Gly polymorphisms for all genetic models. When stratified by ethnicity, statistical association was found among Asians for Gly49Gly versus Ser49Ser (OR 4.56; 95% CI 1.36-15.23; Ph=0.10) and Gly49Gly versus Ser49Ser+Ser49Gly (OR 4.49; 95% CI 1.33-15.15; Ph=0.12), but not among Europeans. In summary, this meta-analysis suggests that no statistically increased risk was found between β1-adrenergic receptor gene polymorphisms and susceptibility to IDCM among Europeans.
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Affiliation(s)
- Bo Jin
- Department of Cardiology, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Shanghai, 200040, China
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