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Shahjahan, Dey JK, Dey SK. Translational bioinformatics approach to combat cardiovascular disease and cancers. ADVANCES IN PROTEIN CHEMISTRY AND STRUCTURAL BIOLOGY 2024; 139:221-261. [PMID: 38448136 DOI: 10.1016/bs.apcsb.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Bioinformatics is an interconnected subject of science dealing with diverse fields including biology, chemistry, physics, statistics, mathematics, and computer science as the key fields to answer complicated physiological problems. Key intention of bioinformatics is to store, analyze, organize, and retrieve essential information about genome, proteome, transcriptome, metabolome, as well as organisms to investigate the biological system along with its dynamics, if any. The outcome of bioinformatics depends on the type, quantity, and quality of the raw data provided and the algorithm employed to analyze the same. Despite several approved medicines available, cardiovascular disorders (CVDs) and cancers comprises of the two leading causes of human deaths. Understanding the unknown facts of both these non-communicable disorders is inevitable to discover new pathways, find new drug targets, and eventually newer drugs to combat them successfully. Since, all these goals involve complex investigation and handling of various types of macro- and small- molecules of the human body, bioinformatics plays a key role in such processes. Results from such investigation has direct human application and thus we call this filed as translational bioinformatics. Current book chapter thus deals with diverse scope and applications of this translational bioinformatics to find cure, diagnosis, and understanding the mechanisms of CVDs and cancers. Developing complex yet small or long algorithms to address such problems is very common in translational bioinformatics. Structure-based drug discovery or AI-guided invention of novel antibodies that too with super-high accuracy, speed, and involvement of considerably low amount of investment are some of the astonishing features of the translational bioinformatics and its applications in the fields of CVDs and cancers.
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Affiliation(s)
- Shahjahan
- Laboratory for Structural Biology of Membrane Proteins, Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India
| | - Joy Kumar Dey
- Central Council for Research in Homoeopathy, Ministry of Ayush, Govt. of India, New Delhi, Delhi, India
| | - Sanjay Kumar Dey
- Laboratory for Structural Biology of Membrane Proteins, Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India.
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Zhang M, Hillegass WB, Yu X, Majumdar S, Daryl Pollard J, Jackson E, Knudson J, Wolfe D, Kato GJ, Maher JF, Mei H. Genetic variants and effect modifiers of QT interval prolongation in patients with sickle cell disease. Gene 2024; 890:147824. [PMID: 37741592 DOI: 10.1016/j.gene.2023.147824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is a common inherited blood disorder among African Americans (AA), with premature mortality which has been associated with prolongation of the heart rate-corrected QT interval (QTc), a known risk factor for sudden cardiac death. Although numerous genetic variants have been identified as contributors to QT interval prolongation in the general population, their impact on SCD patients remains unclear. This study used an unweighted polygenic risk score (PRS) to validate the previously identified associations between SNPs and QTc interval in SCD patients, and to explore possible interactions with other factors that prolong QTc interval in AA individuals with SCD. METHODS In SCD patients, candidate genetic variants associated with the QTc interval were genotyped. To identify any risk SNPs that may be correlated with QTc interval prolongation, linear regression was employed, and an unweighted PRS was subsequently constructed. The effect of PRS on the QTc interval was evaluated using linear regression, while stratification analysis was used to assess the influence of serum alanine transaminase (ALT), a biomarker for liver disease, on the PRS effect. We also evaluated the PRS with the two subcomponents of QTc, the QRS and JTc intervals. RESULTS Out of 26 candidate SNPs, five risk SNPs were identified for QTc duration under the recessive model. For every unit increase in PRS, the QTc interval prolonged by 4.0 ms (95% CI: [2.0, 6.1]; p-value: <0.001) in the additive model and 9.4 ms in the recessive model (95% CI: [4.6, 14.1]; p-value: <0.001). Serum ALT showed a modification effect on PRS-QTc prolongation under the recessive model. In the normal ALT group, each PRS unit increased QTc interval by 11.7 ms (95% CI: [6.3, 17.1]; p-value: 2.60E-5), whereas this effect was not observed in the elevated ALT group (0.9 ms; 95% CI: [-7.0, 8.8]; p-value: 0.823). CONCLUSION Several candidate genetic variants are associated with QTc interval prolongation in SCD patients, and serum ALT acts as a modifying factor. The association of a CPS1 gene variant in both QTc and JTc duration adds to NOS1AP as evidence of involvement of the urea cycle and nitric oxide metabolism in cardiac repolarization in SCD. Larger replication studies are needed to confirm these findings and elucidate the underlying mechanisms.
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Affiliation(s)
- Mengna Zhang
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS 39216, USA; Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - William B Hillegass
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS 39216, USA; Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Xue Yu
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS 39216, USA; Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Suvankar Majumdar
- Division of Hematology, Children's National Hospital, Washington, DC, USA
| | - J Daryl Pollard
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Erin Jackson
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Jarrod Knudson
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Douglas Wolfe
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Gregory J Kato
- Pittsburgh Heart, Lung and Blood Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Joseph F Maher
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA; Department of Internal Medicine/Cancer Genetics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA.
| | - Hao Mei
- Department of Data Science, University of Mississippi Medical Center, Jackson, MS 39216, USA; Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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D’Agostino A, Lanzafame LG, Buono L, Crisci G, D’Assante R, Leone I, De Vito L, Bossone E, Cittadini A, Marra AM. Modulating NO-GC Pathway in Pulmonary Arterial Hypertension. Int J Mol Sci 2023; 25:36. [PMID: 38203205 PMCID: PMC10779316 DOI: 10.3390/ijms25010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/10/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
The pathogenesis of complex diseases such as pulmonary arterial hypertension (PAH) is entirely rooted in changes in the expression of some vasoactive factors. These play a significant role in the onset and progression of the disease. Indeed, PAH has been associated with pathophysiologic alterations in vascular function. These are often dictated by increased oxidative stress and impaired modulation of the nitric oxide (NO) pathway. NO reduces the uncontrolled proliferation of vascular smooth muscle cells that leads to occlusion of vessels and an increase in pulmonary vascular resistances, which is the mainstay of PAH development. To date, two classes of NO-pathway modulating drugs are approved for the treatment of PAH: the phosphodiesterase-5 inhibitors (PD5i), sildenafil and tadalafil, and the soluble guanylate cyclase activator (sGC), riociguat. Both drugs provide considerable improvement in exercise capacity and pulmonary hemodynamics. PD5i are the recommended drugs for first-line PAH treatment, whereas sGCs are also the only drug approved for the treatment of resistant or inoperable chronic thromboembolic pulmonary hypertension. In this review, we will focus on the current information regarding the nitric oxide pathway and its modulation in PAH.
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Affiliation(s)
- Anna D’Agostino
- IRCCS SYNLAB SDN, Via Emanuele Gianturco 113, 80143 Naples, Italy; (A.D.); (L.B.); (I.L.)
| | - Lorena Gioia Lanzafame
- Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122 Catania, Italy;
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy; (G.C.); (R.D.); (L.D.V.); (A.C.)
| | - Lorena Buono
- IRCCS SYNLAB SDN, Via Emanuele Gianturco 113, 80143 Naples, Italy; (A.D.); (L.B.); (I.L.)
| | - Giulia Crisci
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy; (G.C.); (R.D.); (L.D.V.); (A.C.)
| | - Roberta D’Assante
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy; (G.C.); (R.D.); (L.D.V.); (A.C.)
| | - Ilaria Leone
- IRCCS SYNLAB SDN, Via Emanuele Gianturco 113, 80143 Naples, Italy; (A.D.); (L.B.); (I.L.)
| | - Luigi De Vito
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy; (G.C.); (R.D.); (L.D.V.); (A.C.)
| | - Eduardo Bossone
- Department of Public Health, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy;
| | - Antonio Cittadini
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy; (G.C.); (R.D.); (L.D.V.); (A.C.)
- Gender Interdipartimental Institute of Research (GENESIS), “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy
| | - Alberto Maria Marra
- Department of Translational Medical Sciences, “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy; (G.C.); (R.D.); (L.D.V.); (A.C.)
- Gender Interdipartimental Institute of Research (GENESIS), “Federico II” University of Naples, Via Pansini 5, 80131 Naples, Italy
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Smith A, Auer D, Johnson M, Sanchez E, Ross H, Ward C, Chakravarti A, Kapoor A. Cardiac muscle-restricted partial loss of Nos1ap expression has limited but significant impact on electrocardiographic features. G3 (BETHESDA, MD.) 2023; 13:jkad208. [PMID: 37708408 PMCID: PMC10627271 DOI: 10.1093/g3journal/jkad208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/16/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
Genome-wide association studies have identified sequence polymorphisms in a functional enhancer of the NOS1AP gene as the most common genetic regulator of QT interval and human cardiac NOS1AP gene expression in the general population. Functional studies based on in vitro overexpression in murine cardiomyocytes and ex vivo knockdown in zebrafish embryonic hearts, by us and others, have also demonstrated that NOS1AP expression levels can alter cellular electrophysiology. Here, to explore the role of NOS1AP in cardiac electrophysiology at an organismal level, we generated and characterized constitutive and heart muscle-restricted Nos1ap knockout mice to assess whether NOS1AP disruption alters the QT interval in vivo. Constitutive loss of Nos1ap led to genetic background-dependent variable lethality at or right before birth. Heart muscle-restricted Nos1ap knockout, generated using cardiac-specific alpha-myosin heavy chain promoter-driven tamoxifen-inducible Cre, resulted in tissue-level Nos1ap expression reduced by half. This partial loss of expression had no detectable effect on the QT interval or other electrocardiographic and echocardiographic parameters, except for a small but significant reduction in the QRS interval. Given that challenges associated with defining the end of the T wave on murine electrocardiogram can limit identification of subtle effects on the QT interval and that common noncoding NOS1AP variants are also associated with the QRS interval, our findings support the role of NOS1AP in regulation of the cardiac electrical cycle.
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Affiliation(s)
- Alexa Smith
- Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Dallas Auer
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Morgan Johnson
- Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Ernesto Sanchez
- Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Holly Ross
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Christopher Ward
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Aravinda Chakravarti
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Center for Human Genetics and Genomics, New York University School of Medicine, New York, NY 10016, USA
| | - Ashish Kapoor
- Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Wen Z, Long J, Zhu L, Liu S, Zeng X, Huang D, Qiu X, Su L. Associations of dietary, sociodemographic, and anthropometric factors with anemia among the Zhuang ethnic adults: a cross-sectional study in Guangxi Zhuang Autonomous Region, China. BMC Public Health 2023; 23:1934. [PMID: 37803356 PMCID: PMC10557179 DOI: 10.1186/s12889-023-16697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 09/04/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND After decades of rapid economic development, anemia remains a significant public health challenge globally. This study aimed to estimate the associations of sociodemographic, dietary, and body composition factors with anemia among the Zhuang in Guangxi Zhuang Autonomous Region, China. METHODS Our study population from the baseline survey of the Guangxi ethnic minority Cohort Study of Chronic Diseases consisted of 13,465 adults (6,779 women and 6,686 men) aged 24-82 years. A validated interviewer-administered laptop-based questionnaire system was used to collect information on participants' sociodemographic, lifestyle, and dietary factors. Each participant underwent a physical examination, and hematological indices were measured. Least absolute shrinkage and selection operator (LASSO) regression was used to select the variables, and logistic regression was applied to estimate the associations of independent risk factors with anemia. RESULTS The overall prevalences of anemia in men and women were 9.63% (95% CI: 8.94-10.36%) and 18.33% (95% CI: 17.42─19.28%), respectively. LASSO and logistic regression analyses showed that age was positively associated with anemia for both women and men. For diet in women, red meat consumption for 5-7 days/week (OR = 0.79, 95% CI: 0.65-0.98, p = 0.0290) and corn/sweet potato consumption for 5-7 days/week (OR = 0.73, 95% CI: 0.55-0.96, p = 0.0281) were negatively associated with anemia. For men, fruit consumption for 5-7 days/week (OR = 0.75, 95% CI: 0.60-0.94, p = 0.0130) and corn/sweet potato consumption for 5-7 days/week (OR = 0.66, 95% CI: 0.46-0.91, p = 0.0136) were negatively correlated with anemia. Compared with a normal body water percentage (55-65%), a body water percentage below normal (< 55%) was negatively related to anemia (OR = 0.68, 95% CI: 0.53-0.86, p = 0.0014). Conversely, a body water percentage above normal (> 65%) was positively correlated with anemia in men (OR = 1.73, 95% CI: 1.38-2.17, p < 0.0001). CONCLUSIONS Anemia remains a moderate public health problem for premenopausal women and the elderly population in the Guangxi Zhuang minority region. The prevention of anemia at the population level requires multifaceted intervention measures according to sex and age, with a focus on dietary factors and the control of body composition.
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Affiliation(s)
- Zheng Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jianxiong Long
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lulu Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Shun Liu
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaoyun Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, Guangxi, China
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Dongping Huang
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, Guangxi, China.
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Li Su
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, Guangxi, China.
- Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, 530021, Guangxi, China.
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Marijon E, Narayanan K, Smith K, Barra S, Basso C, Blom MT, Crotti L, D'Avila A, Deo R, Dumas F, Dzudie A, Farrugia A, Greeley K, Hindricks G, Hua W, Ingles J, Iwami T, Junttila J, Koster RW, Le Polain De Waroux JB, Olasveengen TM, Ong MEH, Papadakis M, Sasson C, Shin SD, Tse HF, Tseng Z, Van Der Werf C, Folke F, Albert CM, Winkel BG. The Lancet Commission to reduce the global burden of sudden cardiac death: a call for multidisciplinary action. Lancet 2023; 402:883-936. [PMID: 37647926 DOI: 10.1016/s0140-6736(23)00875-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 09/01/2023]
Abstract
Despite major advancements in cardiovascular medicine, sudden cardiac death (SCD) continues to be an enormous medical and societal challenge, claiming millions of lives every year. Efforts to prevent SCD are hampered by imperfect risk prediction and inadequate solutions to specifically address arrhythmogenesis. Although resuscitation strategies have witnessed substantial evolution, there is a need to strengthen the organisation of community interventions and emergency medical systems across varied locations and health-care structures. With all the technological and medical advances of the 21st century, the fact that survival from sudden cardiac arrest (SCA) remains lower than 10% in most parts of the world is unacceptable. Recognising this urgent need, the Lancet Commission on SCD was constituted, bringing together 30 international experts in varied disciplines. Consistent progress in tackling SCD will require a completely revamped approach to SCD prevention, with wide-sweeping policy changes that will empower the development of both governmental and community-based programmes to maximise survival from SCA, and to comprehensively attend to survivors and decedents' families after the event. International collaborative efforts that maximally leverage and connect the expertise of various research organisations will need to be prioritised to properly address identified gaps. The Commission places substantial emphasis on the need to develop a multidisciplinary strategy that encompasses all aspects of SCD prevention and treatment. The Commission provides a critical assessment of the current scientific efforts in the field, and puts forth key recommendations to challenge, activate, and intensify efforts by both the scientific and global community with new directions, research, and innovation to reduce the burden of SCD worldwide.
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Affiliation(s)
- Eloi Marijon
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France.
| | - Kumar Narayanan
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Medicover Hospitals, Hyderabad, India
| | - Karen Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Silverchain Group, Melbourne, VIC, Australia
| | - Sérgio Barra
- Department of Cardiology, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | - Cristina Basso
- Cardiovascular Pathology Unit-Azienda Ospedaliera and Department of Cardiac Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Marieke T Blom
- Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Lia Crotti
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Cardiomyopathy Unit and Laboratory of Cardiovascular Genetics, Department of Cardiology, Milan, Italy
| | - Andre D'Avila
- Department of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Cardiology, Hospital SOS Cardio, Santa Catarina, Brazil
| | - Rajat Deo
- Department of Cardiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Florence Dumas
- Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France; Emergency Department, Cochin Hospital, Paris, France
| | - Anastase Dzudie
- Cardiology and Cardiac Arrhythmia Unit, Department of Internal Medicine, DoualaGeneral Hospital, Douala, Cameroon; Yaounde Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
| | - Audrey Farrugia
- Hôpitaux Universitaires de Strasbourg, France, Strasbourg, France
| | - Kaitlyn Greeley
- Division of Cardiology, European Georges Pompidou Hospital, AP-HP, Paris, France; Université Paris Cité, Inserm, PARCC, Paris, France; Paris-Sudden Death Expertise Center (Paris-SDEC), Paris, France
| | | | - Wei Hua
- Cardiac Arrhythmia Center, FuWai Hospital, Beijing, China
| | - Jodie Ingles
- Centre for Population Genomics, Garvan Institute of Medical Research and UNSW Sydney, Sydney, NSW, Australia
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Japan
| | - Juhani Junttila
- MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Rudolph W Koster
- Heart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Theresa M Olasveengen
- Department of Anesthesia and Intensive Care Medicine, Oslo University Hospital and Institute of Clinical Medicine, Oslo, Norway
| | - Marcus E H Ong
- Singapore General Hospital, Duke-NUS Medical School, Singapore
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George's University of London, London, UK
| | | | - Sang Do Shin
- Department of Emergency Medicine at the Seoul National University College of Medicine, Seoul, South Korea
| | - Hung-Fat Tse
- University of Hong Kong, School of Clinical Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Zian Tseng
- Division of Cardiology, UCSF Health, University of California, San Francisco Medical Center, San Francisco, California
| | - Christian Van Der Werf
- University of Amsterdam, Heart Center, Amsterdam, Netherlands; Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Fredrik Folke
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Bo Gregers Winkel
- Department of Cardiology, University Hospital Copenhagen, Rigshospitalet, Copenhagen, Denmark
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7
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Maurya S, Mills RW, Kahnert K, Chiang DY, Bertoli G, Lundegaard PR, Duran MPH, Zhang M, Rothenberg E, George AL, MacRae CA, Delmar M, Lundby A. Outlining cardiac ion channel protein interactors and their signature in the human electrocardiogram. NATURE CARDIOVASCULAR RESEARCH 2023; 2:673-692. [PMID: 38666184 PMCID: PMC11041666 DOI: 10.1038/s44161-023-00294-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 05/31/2023] [Indexed: 04/28/2024]
Abstract
Protein-protein interactions are essential for normal cellular processes and signaling events. Defining these interaction networks is therefore crucial for understanding complex cellular functions and interpretation of disease-associated gene variants. We need to build a comprehensive picture of the interactions, their affinities and interdependencies in the specific organ to decipher hitherto poorly understood signaling mechanisms through ion channels. Here we report the experimental identification of the ensemble of protein interactors for 13 types of ion channels in murine cardiac tissue. Of these, we validated the functional importance of ten interactors on cardiac electrophysiology through genetic knockouts in zebrafish, gene silencing in mice, super-resolution microscopy and patch clamp experiments. Furthermore, we establish a computational framework to reconstruct human cardiomyocyte ion channel networks from deep proteome mapping of human heart tissue and human heart single-cell gene expression data. Finally, we integrate the ion channel interactome with human population genetics data to identify proteins that influence the electrocardiogram (ECG). We demonstrate that the combined channel network is enriched for proteins influencing the ECG, with 44% of the network proteins significantly associated with an ECG phenotype. Altogether, we define interactomes of 13 major cardiac ion channels, contextualize their relevance to human electrophysiology and validate functional roles of ten interactors, including two regulators of the sodium current (epsin-2 and gelsolin). Overall, our data provide a roadmap for our understanding of the molecular machinery that regulates cardiac electrophysiology.
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Affiliation(s)
- Svetlana Maurya
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Robert W. Mills
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Konstantin Kahnert
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - David Y. Chiang
- Cardiovascular Medicine Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Giorgia Bertoli
- Division of Cardiology, NYU School of Medicine, New York, NY USA
| | - Pia R. Lundegaard
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Mingliang Zhang
- Division of Cardiology, NYU School of Medicine, New York, NY USA
| | - Eli Rothenberg
- Division of Pharmacology, NYU School of Medicine, New York, NY USA
| | - Alfred L. George
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Calum A. MacRae
- Cardiovascular Medicine Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Mario Delmar
- Division of Cardiology, NYU School of Medicine, New York, NY USA
| | - Alicia Lundby
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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8
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Jänsch M, Lubomirov LT, Trum M, Williams T, Schmitt J, Schuh K, Qadri F, Maier LS, Bader M, Ritter O. Inducible over-expression of cardiac Nos1ap causes short QT syndrome in transgenic mice. FEBS Open Bio 2022; 13:118-132. [PMID: 36352324 PMCID: PMC9808597 DOI: 10.1002/2211-5463.13520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/24/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
Recent evidence demonstrated that alterations in the QT interval duration on the ECG are not only determined by mutations in genes for ion channels, but also by modulators of ion channels. Changes in the QT interval duration beyond certain thresholds are pathological and can lead to sudden cardiac death. We here focus on the ion channel modulator nitric oxide synthase 1 adaptor protein (Nos1ap). Whole-cell patch-clamp measurements of a conditional transgenic mouse model exhibiting cardiac-specific Nos1ap over-expression revealed a Nos1ap-dependent increase of L-type calcium channel nitrosylation, which led to increased susceptibility to ventricular tachycardias associated with a decrease in QT duration and shortening of APD90 duration. Survival was significantly reduced (60% after 12 weeks vs. 100% in controls). Examination of the structural features of the hearts of transgenic mice revealed constant heart dimensions and wall thickness without abnormal fibrosis content or BNP production after 3 months of Nos1ap over-expression compared to controls. Nos1ap over-expression did not alter cGMP production or ROS concentration. Our study showed that myocardial over-expression of Nos1ap leads to the shortening of the QT interval and reduces the survival rate of transgenic animals, perhaps via the development of ventricular arrhythmias. We conclude that Nos1ap overexpression causes targeted subcellular localization of Nos1 to the CaV1.2 with a subsequent decrease of ADP90 and the QT interval. This causes detrimental cardiac arrhythmias in transgenic mice.
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Affiliation(s)
- Monique Jänsch
- Department of Cardiology, Nephrology and Pneumology, Brandenburg Medical SchoolUniversity Hospital BrandenburgGermany
| | | | - Maximilian Trum
- Department of Internal Medicine IIUniversity Hospital RegensburgGermany
| | - Tatjana Williams
- Comprehensive Heart Failure Center and Department of Internal Medicine IUniversity Hospital WürzburgGermany
| | - Joachim Schmitt
- Department of Pharmacology and Clinical PharmacologyHeinrich Heine UniversityDüsseldorfGermany
| | - Kai Schuh
- Institute of PhysiologyUniversity of WürzburgGermany
| | - Fatimunnisa Qadri
- Max‐Delbrück‐Center for Molecular Medicine in the Helmholtz Association (MDC)BerlinGermany
| | - Lars S. Maier
- Department of Internal Medicine IIUniversity Hospital RegensburgGermany
| | - Michael Bader
- Max‐Delbrück‐Center for Molecular Medicine in the Helmholtz Association (MDC)BerlinGermany,German Center for Cardiovascular Research (DZHK)BerlinGermany,Charité University MedicineBerlinGermany,Institute for BiologyUniversity of LübeckGermany
| | - Oliver Ritter
- Department of Cardiology, Nephrology and Pneumology, Brandenburg Medical SchoolUniversity Hospital BrandenburgGermany,Department of Cardiology and Pneumology, Clinic for Internal Medicine IUniversity Hospital BrandenburgGermany,Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology Cottbus – SenftenbergThe Brandenburg Medical School Theodor Fontane and the University of PotsdamGermany
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9
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Chang KC, Chen KW, Huang CL, Liao WL, Wu MY, Lin YK, Shiao YT, Chung WH, Lin YN, Lane HY. Association of a Common NOS1AP Variant with Attenuation of QTc Prolongation in Men with Heroin Dependence Undergoing Methadone Treatment. J Pers Med 2022; 12:jpm12050835. [PMID: 35629257 PMCID: PMC9143734 DOI: 10.3390/jpm12050835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/20/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The effects of methadone-induced severe prolongation of the corrected QT interval (QTc) and sudden cardiac death appear unpredictable and sex-dependent. Genetic polymorphisms in the nitric oxide synthase 1 adaptor protein (NOS1AP) have been implicated in QTc prolongation in general populations. We investigated whether common NOS1AP variants interact with methadone in relation to QTc prolongation in patients with heroin dependence. Methods: We genotyped 17 NOS1AP variants spanning the entire gene in heroin-dependent patients who received a 12-lead electrocardiography (ECG) examination both at baseline and during maintenance methadone treatment in Cohort 1 and only during maintenance methadone treatment in Cohort 2. The QT interval was measured automatically by the Marquette 12SL program, and was corrected for heart rate using Bazett’s formula. Results: Cohort 1 consisted of 122 patients (age: 37.65 ± 8.05 years, 84% male, methadone dosage: 42.54 ± 22.17 mg/day), and Cohort 2 comprised of 319 patients (age: 36.9 ± 7.86 years, 82% male, methadone dosage: 26.08 ± 15.84 mg/day), with complete genotyping data for analyses. Before methadone, the QTc intervals increased with increasing age (r = 0.3541, p < 0.001); the age-adjusted QTc showed dose-dependent prolongation in men (r = 0.6320, p < 0.001), but abbreviation in women (r = −0.5348, p = 0.018) in Cohort 1. The pooled genotype-specific analysis of the two cohorts revealed that the QTc interval was significantly shorter in male carriers of the rs164148 AA variant than in male carriers of the reference GG genotype (GG: n = 262, QTc = 423 ± 1.4 ms; AA: n = 10, QTc = 404.1 ± 7 ms, p = 0.009), according to univariate analysis. The QTc remained shorter in male carriers of the rs164148 AA variant compared to GG genotype (423 ± 1.4 ms vs. 405.9 ± 6.9 ms, p = 0.016) in multivariate analysis after adjusting for age and methadone dosage. A cut-off QTc interval of <410 ms identifies 100% of AA carriers compared to none of GG carriers when receiving a daily methadone dosage of 30.6 ± 19.3 mg. There was no significant gene-drug interaction in contributing to the adjusted QTc (p = 0.2164) in male carriers of the rs164148 variants. Conclusions: Carriers of a common NOS1AP rs164148 AA genotype variant were associated with a shorter QTc interval in men receiving maintenance methadone treatment. This genetic polymorphism attenuates the QTc-prolonging effect by methadone, and thus may explain at least in part the unpredictable and heterogeneous risks for severe QTc prolongation and sudden cardiac death in patients on methadone.
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Affiliation(s)
- Kuan-Cheng Chang
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
- Correspondence: ; Tel.: +886-4-22052121 (ext. 2626); Fax: +886-4-22065593
| | - Ke-Wei Chen
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
| | - Chieh-Liang Huang
- Department of Addiction Treatment, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County 54249, Taiwan;
| | - Wen-Ling Liao
- Center for Personalized Medicine, China Medical University Hospital, Taichung 404332, Taiwan;
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404333, Taiwan
| | - Mei-Yao Wu
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 40402, Taiwan;
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404332, Taiwan
| | - Yu-Kai Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
| | - Yi-Tzone Shiao
- Center of Institutional Research and Development, Asia University, Taichung 413305, Taiwan;
| | - Wei-Hsin Chung
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
| | - Yen-Nien Lin
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung 404332, Taiwan; (K.-W.C.); (Y.-K.L.); (W.-H.C.); (Y.-N.L.)
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404333, Taiwan;
- Department of Psychiatry, China Medical University Hospital, Taichung 404332, Taiwan
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10
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Zang X, Zhang S, Li S, Wang X, Song W, Chen K, Ma J, Tu X, Xia Y, Zhao Y, Gao C. Evaluating Common NOS1AP Variants in Patients with Implantable Cardioverter Defibrillators for Secondary Prevention : Evaluating SNPs in NOS1AP. J Interv Card Electrophysiol 2022; 64:793-800. [PMID: 35353321 DOI: 10.1007/s10840-022-01137-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 01/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent research has found that single nucleotide polymorphisms (SNPs) in the nitric oxide synthase 1 adaptor protein (NOS1AP) gene are associated with altered QT intervals and sudden cardiac death (SCD). However, the clinical utility and implications of NOS1AP SNPs remain unclear. Thus, this study aimed to explore the influence of NOS1AP SNPs in patients with implantable cardioverter defibrillator (ICD) for secondary prevention. METHODS We conducted a case-control study to evaluate the most studied SNPs in NOS1AP (rs12143842, rs10494366, rs12567209, and rs16847548) in patients with ICD for secondary prevention. Patients were followed for up to 36 months from the time of ICD implantation. ICD interrogation data at 3 and 12 months, including rapid ventricular arrhythmia episodes and appropriate therapies, were then analyzed. RESULTS: A significant association was observed between rs10494366 and ICD recipients who experienced appropriate therapies. After a mean follow-up time of 31.70 ± 9.15 months, we detected significant differences among the three rs10494366 genotype groups in the distribution of ICD shocks and appropriate therapies, as well as in the correlation of rs10494366 and ICD shocks. According to Kaplan-Meier and Cox regression analyses, patients with the TT genotype had a higher risk of SCD than those with the GG genotype. CONCLUSIONS The present study revealed that NOS1AP SNP rs10494366 was associated with appropriate therapies. Specifically, the TT genotype increased ICD shocks and SCD risk in patients with ICD for secondary prevention for the first time.
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Affiliation(s)
- Xiaobiao Zang
- Department of Cardiology, Peoples Hospital of Zhengzhou University Henan Provincial Peoples Hospital, Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou, China
| | - Shulong Zhang
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Sisi Li
- Gannan Medical University, Jiangxi, China
| | - Xianqing Wang
- Department of Cardiology, Peoples Hospital of Zhengzhou University Henan Provincial Peoples Hospital, Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou, China
| | - Weifeng Song
- Department of Cardiology, Peoples Hospital of Zhengzhou University Henan Provincial Peoples Hospital, Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou, China
| | - Ke Chen
- Department of Cardiology, Peoples Hospital of Zhengzhou University Henan Provincial Peoples Hospital, Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou, China
| | - Jifang Ma
- Department of Cardiology, Peoples Hospital of Zhengzhou University Henan Provincial Peoples Hospital, Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou, China
| | - Xin Tu
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology, Wuhan, China
| | - Yunlong Xia
- First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yonghui Zhao
- Department of Cardiology, Peoples Hospital of Zhengzhou University Henan Provincial Peoples Hospital, Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou, China.
| | - Chuanyu Gao
- Department of Cardiology, Peoples Hospital of Zhengzhou University Henan Provincial Peoples Hospital, Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou, China.
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11
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A NOS1AP gene variant is associated with a paradoxical increase of the QT-interval shortening effect of digoxin. THE PHARMACOGENOMICS JOURNAL 2022; 22:55-61. [PMID: 34616002 DOI: 10.1038/s41397-021-00256-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 09/20/2021] [Indexed: 02/07/2023]
Abstract
Digoxin is characterized by a small therapeutic window and a QT-interval shortening effect. Moreover, it has been shown that the genetic variants of the nitric oxide synthase-1 adaptor protein (NOS1AP) gene are associated with QT-interval prolongation. We investigated whether the rs10494366 variant of the NOS1AP gene decreases the QT-interval shortening effect of digoxin in patients using this drug. We included 10,057 individuals from the prospective population-based cohort of the Rotterdam Study during a median of 12.2 (interquartile range (IQR) 6.7-18.1) years of follow-up. At study entry, the mean age was 64 years and almost 59% of participants were women. A total of 23,179 ECGs were longitudinally recorded, of which 334 ECGs were from 249 individuals on digoxin therapy. The linear mixed model analysis was used to estimate the effect of the rs10494366 variant on the association between digoxin use and QT-interval duration, adjusted for age, sex, RR interval, diabetes, heart failure, and history of myocardial infarction. In non-users of digoxin, the GG genotype was associated with a significant 6.5 ms [95% confidence interval (CI) 5.5; 7.5] longer QT-interval duration than the TT variant. In current digoxin users, however, the GG variant was associated with a significantly -23.9 [95%CI -29.5; -18.5] ms shorter mean QT-interval duration than in those with the TT variant with -15.9 [95%CI -18.7; -13.1]. This reduction was strongest in the high digoxin dose category [≥0.250 mg/day] with the GG genotype group, with -40.8 [95%CI -52.5; -29.2] ms changes compared to non-users. Our study suggests that the minor homozygous GG genotype group of the NOS1AP gene rs10494366 variant is associated with a paradoxical increase of the QT-interval shortening effect of digoxin in a population of European ancestry.
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12
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Solanki K, Rajpoot S, Bezsonov EE, Orekhov AN, Saluja R, Wary A, Axen C, Wary K, Baig MS. The expanding roles of neuronal nitric oxide synthase (NOS1). PeerJ 2022; 10:e13651. [PMID: 35821897 PMCID: PMC9271274 DOI: 10.7717/peerj.13651] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/07/2022] [Indexed: 01/17/2023] Open
Abstract
The nitric oxide synthases (NOS; EC 1.14.13.39) use L-arginine as a substrate to produce nitric oxide (NO) as a by-product in the tissue microenvironment. NOS1 represents the predominant NO-producing enzyme highly enriched in the brain and known to mediate multiple functions, ranging from learning and memory development to maintaining synaptic plasticity and neuronal development, Alzheimer's disease (AD), psychiatric disorders and behavioral deficits. However, accumulating evidence indicate both canonical and non-canonical roles of NOS1-derived NO in several other tissues and chronic diseases. A better understanding of NOS1-derived NO signaling, and identification and characterization of NO-metabolites in non-neuronal tissues could become useful in diagnosis and prognosis of diseases associated with NOS1 expression. Continued investigation on the roles of NOS1, therefore, will synthesize new knowledge and aid in the discovery of small molecules which could be used to titrate the activities of NOS1-derived NO signaling and NO-metabolites. Here, we address the significance of NOS1 and its byproduct NO in modifying pathophysiological events, which could be beneficial in understanding both the disease mechanisms and therapeutics.
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Affiliation(s)
- Kundan Solanki
- Department of Biosciences and Biomedical Engineering (BSBE), Indian Institute of Technology Indore (IITI), Simrol, Indore, India
| | - Sajjan Rajpoot
- Department of Biosciences and Biomedical Engineering (BSBE), Indian Institute of Technology Indore (IITI), Simrol, Indore, India
| | - Evgeny E Bezsonov
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Moscow, Russia.,Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia.,Department of Biology and General Genetics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Alexander N Orekhov
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Federal State Budgetary Scientific Institution "Petrovsky National Research Centre of Surgery", Moscow, Russia.,Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - Rohit Saluja
- Department of Biochemistry, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India
| | - Anita Wary
- Pharmacology and Regenerative Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Cassondra Axen
- Pharmacology and Regenerative Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Kishore Wary
- Pharmacology and Regenerative Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Mirza S Baig
- Department of Biosciences and Biomedical Engineering (BSBE), Indian Institute of Technology Indore (IITI), Simrol, Indore, India
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13
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Scrocco C, Bezzina CR, Ackerman MJ, Behr ER. Genetics and genomics of arrhythmic risk: current and future strategies to prevent sudden cardiac death. Nat Rev Cardiol 2021; 18:774-784. [PMID: 34031597 DOI: 10.1038/s41569-021-00555-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 02/04/2023]
Abstract
A genetic risk of sudden cardiac arrest and sudden death due to an arrhythmic cause, known as sudden cardiac death (SCD), has become apparent from epidemiological studies in the general population and in patients with ischaemic heart disease. However, genetic susceptibility to sudden death is greatest in young people and is associated with uncommon, monogenic forms of heart disease. Despite comprehensive pathology and genetic evaluations, SCD remains unexplained in a proportion of young people and is termed sudden arrhythmic death syndrome, which poses challenges to the identification of relatives from affected families who might be at risk of SCD. In this Review, we assess the current understanding of the epidemiology and causes of SCD and evaluate both the monogenic and the polygenic contributions to the risk of SCD in the young and SCD associated with drug therapy. Finally, we analyse the potential clinical role of genomic testing in the prevention of SCD in the general population.
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Affiliation(s)
- Chiara Scrocco
- Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St George's University of London and St George's University Hospitals NHS Foundation Trust, London, UK
| | - Connie R Bezzina
- Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Michael J Ackerman
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology & Experimental Therapeutics; Divisions of Heart Rhythm Services and Pediatric Cardiology, Mayo Clinic, Rochester, MN, USA.,Windland Smith Rice Genetic Heart Rhythm Clinic and the Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Elijah R Behr
- Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St George's University of London and St George's University Hospitals NHS Foundation Trust, London, UK.
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14
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Joshi A, Rienks M, Theofilatos K, Mayr M. Systems biology in cardiovascular disease: a multiomics approach. Nat Rev Cardiol 2021; 18:313-330. [PMID: 33340009 DOI: 10.1038/s41569-020-00477-1] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 12/13/2022]
Abstract
Omics techniques generate large, multidimensional data that are amenable to analysis by new informatics approaches alongside conventional statistical methods. Systems theories, including network analysis and machine learning, are well placed for analysing these data but must be applied with an understanding of the relevant biological and computational theories. Through applying these techniques to omics data, systems biology addresses the problems posed by the complex organization of biological processes. In this Review, we describe the techniques and sources of omics data, outline network theory, and highlight exemplars of novel approaches that combine gene regulatory and co-expression networks, proteomics, metabolomics, lipidomics and phenomics with informatics techniques to provide new insights into cardiovascular disease. The use of systems approaches will become necessary to integrate data from more than one omic technique. Although understanding the interactions between different omics data requires increasingly complex concepts and methods, we argue that hypothesis-driven investigations and independent validation must still accompany these novel systems biology approaches to realize their full potential.
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Affiliation(s)
- Abhishek Joshi
- King's British Heart Foundation Centre, King's College London, London, UK
- Bart's Heart Centre, St. Bartholomew's Hospital, London, UK
| | - Marieke Rienks
- King's British Heart Foundation Centre, King's College London, London, UK
| | | | - Manuel Mayr
- King's British Heart Foundation Centre, King's College London, London, UK.
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15
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Jin Y, Song S, Zhang L, Trisolini MG, Labresh KA, Smith SC, Zheng Z. Disparities in Premature Cardiac Death Among US Counties From 1999-2017: Temporal Trends and Key Drivers. J Am Heart Assoc 2020; 9:e016340. [PMID: 32750296 PMCID: PMC7792253 DOI: 10.1161/jaha.120.016340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
Background Disparities in premature cardiac death (PCD) might stagnate the progress toward the reduction of PCD in the United States and worldwide. We estimated disparities across US counties in PCD rates and investigated county-level factors related to the disparities. Methods and Results We used US mortality data for cause-of-death and demographic data from death certificates and county-level characteristics data from multiple databases. PCD was defined as any death that occurred at an age between 35 and 74 years with an underlying cause of death caused by cardiac disease based on International Classification of Diseases, Tenth Revision (ICD-10), codes. Of the 1 598 173 PCDs that occurred during 1999-2017, 60.9% were out of hospital. Although the PCD rates declined from 1999-2017, the proportion of out-of-hospital PCDs among all cardiac deaths increased from 58.3% to 61.5%. The geographic disparities in PCD rates across counties widened from 1999 (Theil index=0.10) to 2017 (Theil index=0.23), and within-state differences accounted for the majority of disparities (57.4% in 2017). The disparities in out-of-hospital PCD rates (and in-hospital PCD rates) associated with demographic composition were 36.51% (and 37.51%), socioeconomic features were 18.64% (and 18.36%), healthcare environment were 18.64% (and 13.90%), and population health status were 23.73% (and 30.23%). Conclusions Disparities in PCD rates exist across US counties, which may be related to the decelerated trend of decline in the rates among middle-aged adults. The slower declines in out-of-hospital rates warrants more precision targeting and sustained efforts to ensure progress at better levels of health (with lower PCD rates) against PCD.
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Affiliation(s)
- Yinzi Jin
- Department of Global HealthSchool of Public HealthPeking UniversityBeijingChina
- Institute for Global HealthPeking UniversityBeijingChina
| | - Suhang Song
- China Center for Health Development StudiesPeking UniversityBeijingChina
| | - Lin Zhang
- School of Public HealthShanghai Jiao Tong UniversityShanghaiChina
| | | | | | - Sidney C. Smith
- Division of CardiologySchool of MedicineUniversity of North Carolina at Chapel HillNC
| | - Zhi‐Jie Zheng
- Department of Global HealthSchool of Public HealthPeking UniversityBeijingChina
- Institute for Global HealthPeking UniversityBeijingChina
- RTI InternationalResearch Triangle ParkNC
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16
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Turkowski KL, Dotzler SM, Tester DJ, Giudicessi JR, Bos JM, Speziale AD, Vollenweider JM, Ackerman MJ. Corrected QT Interval–Polygenic Risk Score and Its Contribution to Type 1, Type 2, and Type 3 Long-QT Syndrome in Probands and Genotype-Positive Family Members. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2020; 13:e002922. [DOI: 10.1161/circgen.120.002922] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background:
Long-QT syndrome (LQTS) is characterized by a prolonged heart rate–corrected QT interval (QTc). Genome-wide association studies identified common genetic variants that collectively explain ≈8% to 10% of QTc variation in the general population.
Methods:
Overall, 423 patients with LQT1, LQT2, or LQT3 were genotyped for 61 QTc-associated genetic variants used in a prototype QTc–polygenic risk score (QTc-PRS). A weighted QTc-PRS (range, 0–154.8 ms) was calculated for each patient, and the FHS (Framingham Heart Study) population-based reference cohort (n=853).
Results:
The average QTc-PRS in LQTS was 88.0±7.2 and explained only ≈2.0% of the QTc variability. The QTc-PRS in LQTS probands (n=137; 89.3±6.8) was significantly greater than both FHS controls (87.2±7.4, difference-in-means±SE: 2.1±0.7,
P
<0.002) and LQTS genotype-positive family members (87.5±7.4, difference-in-mean, 1.8±.7,
P
<0.009). There was no difference in QTc-PRS between symptomatic (n=156, 88.6±7.3) and asymptomatic patients (n=267; 87.7±7.2, difference-in-mean, 0.9±0.7, P=0.15). LQTS patients with a QTc≥480 ms (n=120) had a significantly higher QTc-PRS (89.3±6.7) than patients with a QTc<480 ms (n=303, 87.6±7.4, difference-in-mean, 1.7±0.8,
P
<0.05). There was no difference in QTc-PRS or QTc between genotypes.
Conclusions:
The QTc-PRS explained <2% of the QTc variability in our LQT1, LQT2, and LQT3 cohort, contributing 5× less to their QTc value than in the general population. This prototype QTc-PRS does not distinguish/predict the clinical outcomes of individuals with LQTS.
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Affiliation(s)
- Kari L. Turkowski
- Mayo Clinic Graduate School of Biomedical Sciences (K.L.T., S.M.D.), Mayo Clinic, Rochester, MN, USA
- Windland Smith Rice Sudden Death Genomics Laboratory, Department of Molecular Pharmacology & Experimental Therapeutics (K.L.T., S.M.D., D.J.T., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN, USA
| | - Steven M. Dotzler
- Mayo Clinic Graduate School of Biomedical Sciences (K.L.T., S.M.D.), Mayo Clinic, Rochester, MN, USA
- Windland Smith Rice Sudden Death Genomics Laboratory, Department of Molecular Pharmacology & Experimental Therapeutics (K.L.T., S.M.D., D.J.T., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN, USA
| | - David J. Tester
- Windland Smith Rice Sudden Death Genomics Laboratory, Department of Molecular Pharmacology & Experimental Therapeutics (K.L.T., S.M.D., D.J.T., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN, USA
| | - John R. Giudicessi
- Clinician-Investigator Training Program, Department of Cardiovascular Medicine (J.R.G.), Mayo Clinic, Rochester, MN, USA
| | - J. Martijn Bos
- Windland Smith Rice Sudden Death Genomics Laboratory, Department of Molecular Pharmacology & Experimental Therapeutics (K.L.T., S.M.D., D.J.T., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN, USA
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine (J.M.B., M.J.A.), Mayo Clinic, Rochester, MN, USA
| | - Ashley D. Speziale
- Medical Genome Facility (A.D.S., J.M.V.), Mayo Clinic, Rochester, MN, USA
| | | | - Michael J. Ackerman
- Windland Smith Rice Sudden Death Genomics Laboratory, Department of Molecular Pharmacology & Experimental Therapeutics (K.L.T., S.M.D., D.J.T., J.M.B., M.J.A.), Mayo Clinic, Rochester, MN, USA
- Division of Heart Rhythm Services, Windland Smith Rice Genetic Heart Rhythm Clinic, Department of Cardiovascular Medicine (M.J.A.), Mayo Clinic, Rochester, MN, USA
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine (J.M.B., M.J.A.), Mayo Clinic, Rochester, MN, USA
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17
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Abstract
Susceptibility to atrial fibrillation (AF) is determined by well-recognized risk factors such as diabetes mellitus or hypertension, emerging risk factors such as sleep apnea or inflammation, and increasingly well-defined genetic variants. As discussed in detail in a companion article in this series, studies in families and in large populations have identified multiple genetic loci, specific genes, and specific variants increasing susceptibility to AF. Since it is becoming increasingly inexpensive to obtain genotype data and indeed whole genome sequence data, the question then becomes to define whether using emerging new genetics knowledge can improve care for patients both before and after development of AF. Examples of improvements in care could include identifying patients at increased risk for AF (and thus deploying increased surveillance or even low-risk preventive therapies should these be available), identifying patient subsets in whom specific therapies are likely to be effective or ineffective or in whom the driving biology could motivate the development of new mechanism-based therapies or identifying an underlying susceptibility to comorbid cardiovascular disease. While current guidelines for the care of patients with AF do not recommend routine genetic testing, this rapidly increasing knowledge base suggests that testing may now or soon have a place in the management of select patients. The opportunity is to generate, validate, and deploy clinical predictors (including family history) of AF risk, to assess the utility of incorporating genomic variants into those predictors, and to identify and validate interventions such as wearable or implantable device-based monitoring ultimately to intervene in patients with AF before they present with catastrophic complications like heart failure or stroke.
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Affiliation(s)
- M. Benjamin Shoemaker
- Department of Medicine (Cardiovascular Medicine), Vanderbilt University Medical Center, Nashville, TN
| | - Rajan L. Shah
- Department of Medicine (Cardiovascular Medicine), Stanford University Medical Center, Palo Alto, CA
| | - Dan M. Roden
- Departments of Medicine (Cardiovascular Medicine and Clinical Pharmacology), Pharmacology, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| | - Marco V. Perez
- Stanford Center for Inherited Cardiovascular Diseases, Stanford University, Palo Alto, CA
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18
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Ronchi C, Bernardi J, Mura M, Stefanello M, Badone B, Rocchetti M, Crotti L, Brink P, Schwartz PJ, Gnecchi M, Zaza A. NOS1AP polymorphisms reduce NOS1 activity and interact with prolonged repolarization in arrhythmogenesis. Cardiovasc Res 2020; 117:472-483. [PMID: 32061134 DOI: 10.1093/cvr/cvaa036] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 10/28/2019] [Accepted: 02/10/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS NOS1AP single-nucleotide polymorphisms (SNPs) correlate with QT prolongation and cardiac sudden death in patients affected by long QT syndrome type 1 (LQT1). NOS1AP targets NOS1 to intracellular effectors. We hypothesize that NOS1AP SNPs cause NOS1 dysfunction and this may converge with prolonged action-potential duration (APD) to facilitate arrhythmias. Here we test (i) the effects of NOS1 inhibition and their interaction with prolonged APD in a guinea pig cardiomyocyte (GP-CMs) LQT1 model; (ii) whether pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from LQT1 patients differing for NOS1AP variants and mutation penetrance display a phenotype compatible with NOS1 deficiency. METHODS AND RESULTS In GP-CMs, NOS1 was inhibited by S-Methyl-L-thiocitrulline acetate (SMTC) or Vinyl-L-NIO hydrochloride (L-VNIO); LQT1 was mimicked by IKs blockade (JNJ303) and β-adrenergic stimulation (isoproterenol). hiPSC-CMs were obtained from symptomatic (S) and asymptomatic (AS) KCNQ1-A341V carriers, harbouring the minor and major alleles of NOS1AP SNPs (rs16847548 and rs4657139), respectively. In GP-CMs, NOS1 inhibition prolonged APD, enhanced ICaL and INaL, slowed Ca2+ decay, and induced delayed afterdepolarizations. Under action-potential clamp, switching to shorter APD suppressed 'transient inward current' events induced by NOS1 inhibition and reduced cytosolic Ca2+. In S (vs. AS) hiPSC-CMs, APD was longer and ICaL larger; NOS1AP and NOS1 expression and co-localization were decreased. CONCLUSION The minor NOS1AP alleles are associated with NOS1 loss of function. The latter likely contributes to APD prolongation in LQT1 and converges with it to perturb Ca2+ handling. This establishes a mechanistic link between NOS1AP SNPs and aggravation of the arrhythmia phenotype in prolonged repolarization syndromes.
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Affiliation(s)
- Carlotta Ronchi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 2016 Milano, Italy
| | - Joyce Bernardi
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 2016 Milano, Italy
| | - Manuela Mura
- Department of Cardiothoracic and Vascular Sciences, Fondazione IRCCS Policlinico San Matteo - Laboratory of Experimental Cardiology for Cell and Molecular Therapies, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Manuela Stefanello
- Department of Cardiothoracic and Vascular Sciences, Fondazione IRCCS Policlinico San Matteo - Laboratory of Experimental Cardiology for Cell and Molecular Therapies, Viale Camillo Golgi 19, 27100 Pavia, Italy
| | - Beatrice Badone
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 2016 Milano, Italy
| | - Marcella Rocchetti
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 2016 Milano, Italy
| | - Lia Crotti
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Via Pier Lombardo 22, 20135 Milan, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.,Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy
| | - Paul Brink
- Department of Medicine, University of Stellenbosch, Tygerberg, South Africa
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Via Pier Lombardo 22, 20135 Milan, Italy
| | - Massimiliano Gnecchi
- Department of Cardiothoracic and Vascular Sciences, Fondazione IRCCS Policlinico San Matteo - Laboratory of Experimental Cardiology for Cell and Molecular Therapies, Viale Camillo Golgi 19, 27100 Pavia, Italy.,Unit of Cardiology, Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Antonio Zaza
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza 2, 2016 Milano, Italy.,Cardiovascular Research Institute (CARIM), Maastricht University, Maastricht, Netherlands
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19
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Roden DM, Van Driest SL, Wells QS, Mosley JD, Denny JC, Peterson JF. Opportunities and Challenges in Cardiovascular Pharmacogenomics: From Discovery to Implementation. Circ Res 2019; 122:1176-1190. [PMID: 29700066 DOI: 10.1161/circresaha.117.310965] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This review will provide an overview of the principles of pharmacogenomics from basic discovery to implementation, encompassing application of tools of contemporary genome science to the field (including areas of apparent divergence from disease-based genomics), a summary of lessons learned from the extensively studied drugs clopidogrel and warfarin, the current status of implementing pharmacogenetic testing in practice, the role of genomics and related tools in the drug development process, and a summary of future opportunities and challenges.
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Affiliation(s)
- Dan M Roden
- From the Department of Medicine (D.M.R., S.L.V.D., Q.S.W., J.D.M., J.C.D., J.F.P.) .,Department of Pharmacology (D.M.R., Q.S.W.).,Department of Biomedical Informatics (D.M.R., J.C.D., J.F.P.)
| | - Sara L Van Driest
- From the Department of Medicine (D.M.R., S.L.V.D., Q.S.W., J.D.M., J.C.D., J.F.P.).,Department of Pediatrics (S.L.V.D.), Vanderbilt University Medical Center, Nashville, TN
| | - Quinn S Wells
- From the Department of Medicine (D.M.R., S.L.V.D., Q.S.W., J.D.M., J.C.D., J.F.P.).,Department of Pharmacology (D.M.R., Q.S.W.)
| | - Jonathan D Mosley
- From the Department of Medicine (D.M.R., S.L.V.D., Q.S.W., J.D.M., J.C.D., J.F.P.)
| | - Joshua C Denny
- From the Department of Medicine (D.M.R., S.L.V.D., Q.S.W., J.D.M., J.C.D., J.F.P.).,Department of Biomedical Informatics (D.M.R., J.C.D., J.F.P.)
| | - Josh F Peterson
- From the Department of Medicine (D.M.R., S.L.V.D., Q.S.W., J.D.M., J.C.D., J.F.P.).,Department of Biomedical Informatics (D.M.R., J.C.D., J.F.P.)
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20
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Zang X, Li S, Zhao Y, Chen K, Wang X, Song W, Ma J, Tu X, Xia Y, Zhang S, Gao C. Systematic Meta-Analysis of the Association Between a Common NOS1AP Genetic Polymorphism, the QTc Interval, and Sudden Death. Int Heart J 2019; 60:1083-1090. [PMID: 31447468 DOI: 10.1536/ihj.19-024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Contemporary studies have identified rs10494366 in the nitric oxide synthase 1 adaptor protein (NOS1AP) gene as a new genetic marker in modulating the QT interval and sudden cardiac death (SCD) in general populations. However, the conclusions were not coincident. Therefore, we conducted for the first time a system evaluation of the relativity of rs10494366, the QT interval, and sudden death by meta-analysis. In our study, the meta-analysis displayed the GG genotype of rs10494366 correlated with the QT interval in women with no heterogeneity, and in diabetes mellitus (DM) patients with minor heterogeneity. In the Caucasian population, the correlation of rs10494366 and sudden death was significant. The heterogeneity referred to the relevance between rs10494366 and sudden death in the Asian population. In conclusion, the minor allele of rs10494366 may have an impact on the QT interval in women or DM patients and may have a potential role in sudden death in the Caucasian population.
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Affiliation(s)
- Xiaobiao Zang
- Zhengzhou University People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou University
| | | | - Yonghui Zhao
- Zhengzhou University People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou University
| | - Ke Chen
- Zhengzhou University People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou University
| | - Xianqing Wang
- Zhengzhou University People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou University
| | - Weifeng Song
- Zhengzhou University People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou University
| | - Jifang Ma
- Zhengzhou University People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou University
| | - Xin Tu
- Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology and Center for Human Genome Research, Cardio-X Institute, Huazhong University of Science and Technology
| | - Yunlong Xia
- First Affiliated Hospital of Dalian Medical University
| | - Shulong Zhang
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University
| | - Chuanyu Gao
- Zhengzhou University People's Hospital, Fuwai Central China Cardiovascular Hospital, Zhengzhou University
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21
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Tamariz L, Balda J, Pareja D, Palacio A, Myerburg RJ, Conway D, Davis L, Goldberger JJ. Usefulness of Single Nucleotide Polymorphisms as Predictors of Sudden Cardiac Death. Am J Cardiol 2019; 123:1900-1905. [PMID: 31053292 DOI: 10.1016/j.amjcard.2019.02.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 12/23/2022]
Abstract
The pathophysiology of sudden cardiac death (SCD) remains incompletely understood. Genetic mutations can create a favorable substrate for SCD. Our aim is to evaluate the evidence of single nucleotide polymorphisms (SNPs) as predictors of SCD. We searched the Medline database (2000 to 2017) and selected all case-control or cohort studies that reported associations between SNPs and SCD. Our search terms included "polymorphisms" and "sudden death." We collected the study design, population ethnic background, gene testing strategy, the association between the SNP and SCD, and the cardiovascular comorbidities of the population. Our search yielded 723 studies, of which we included 24 based upon our inclusion criteria. The studies had a total population of 78,165 participants, with a median age of 62.5 years (IQR 56 to 66) and 35% (IQR 13 to 32) were female. Almost all studies were conducted in white patients of European descent and the most commonly used genetic strategy was candidate gene panels. Fifteen of the studies had a case-control design that included SCD patients without known heart disease as the comparison group and the other 9 studies included patients with heart failure and coronary artery disease. The studies evaluated 53 SNPs and the most common genetic loci were SCN5A, RyR2, CASQ2, NOSA1P, and AGTR. SNPs with the 3 strongest statistically significant ORs >1 were: rs6684209 of CASQ2 (odds ratio [OR] 19), rs3814843 of CALM1 (OR 5.5), and rs35594137 of GJA5 (OR 3.6). In Conclusion, many SNPs are associated with SCD, with the strongest associations seen in SNPs of genes related to intracellular calcium handling. These findings were generated primarily using a candidate gene strategy in white patients with European descent.
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Affiliation(s)
- Leonardo Tamariz
- Division of Population Health and Computational Medicine, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida; the Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, Miami, Florida.
| | - Javier Balda
- Department of Medicine, St Elizabeths Medical Center, Boston, Massachusetts; Universidad Catolica Santiago de Guayaquil, Guayaquil, Ecuador
| | - Dennise Pareja
- the Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, Miami, Florida; Universidad Catolica Santiago de Guayaquil, Guayaquil, Ecuador
| | - Ana Palacio
- Division of Population Health and Computational Medicine, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida; the Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center, Miami, Florida
| | - Robert J Myerburg
- Division of Cardiology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
| | - Douglas Conway
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
| | - Lea Davis
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
| | - Jeffrey J Goldberger
- Division of Cardiology, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
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22
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Abstract
PURPOSE OF REVIEW The current article provides a concise summary of the possibilities and limitations of genotype-based risk stratification of cardiac arrhythmias. We will outline the most important findings of the recent years in the light of their chronological and conceptual development. RECENT FINDINGS Genotype-phenotype association studies in families with single-gene disorders as well as in the general population led to the discovery of several DNA variants significantly associated with the risk of sudden death or life-threatening arrhythmias. In genetic (monogenic) diseases, the disease-causing mutations modulate the risk of events and response to antiarrhythmic therapy according to the specific gene involved, to their position of the mutation and to their functional effects. These causal relationships have been quite well characterized in the case of long QT syndrome but are still less defined in the case of other inherited conditions. Quantitatively, the risk associated with a single genetic variant is large for DNA variants that cause monogenic inherited arrhythmias. Much different is the case of more common variants associated with the risk of arrhythmias in the general population as they are generally associated with a small effect size. SUMMARY Genetic profiling identifies arrhythmogenic risk even if a complete picture allowing high-granularity risk stratification is yet to come.
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23
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Dusi V, De Ferrari GM, Pugliese L, Schwartz PJ. Cardiac Sympathetic Denervation in Channelopathies. Front Cardiovasc Med 2019; 6:27. [PMID: 30972341 PMCID: PMC6443634 DOI: 10.3389/fcvm.2019.00027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/01/2019] [Indexed: 12/24/2022] Open
Abstract
Left cardiac sympathetic denervation (LCSD) is a surgical antiadrenergic intervention with a strong antiarrhythmic effect, supported by preclinical as well as clinical data. The mechanism of action of LCSD in structurally normal hearts with increased arrhythmic susceptibility (such as those of patients with channelopathies) is not limited to the antagonism of acute catecholamines release in the heart. LCSD also conveys a strong anti-fibrillatory action that was first demonstrated over 40 years ago and provides the rationale for its use in almost any cardiac condition at increased risk of ventricular fibrillation. The molecular mechanisms involved in the final antiarrhythmic effect of LCSD turned out to be much broader than anticipated. Beside the vagotonic effect at different levels of the neuraxis, other new mechanisms have been recently proposed, such as the antagonism of neuronal remodeling, the antagonism of neuropeptide Y effects, and the correction of neuronal nitric oxide synthase (nNOS) imbalance. The beneficial effects of LCSD have never been associated with a detectable deterioration of cardiac performance. Finally, patients express a high degree of satisfaction with the procedure. In this review, we focus on the rationale, results and our personal approach to LCSD in patients with channelopathies such as long QT syndrome and catecholaminergic polymorphic ventricular tachycardia.
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Affiliation(s)
- Veronica Dusi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy.,Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gaetano Maria De Ferrari
- Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy.,Cardiac Intensive Care Unit, Arrhythmia and Electrophysiology and Experimental Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Luigi Pugliese
- Unit of General Surgery 2, Department of Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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24
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Zhang J, Sun Y, Liu M, Sun C, Tian L. Predictive and Diagnostic Value of Fractional Exhaled Nitric Oxide in Patients with Chronic Rhinosinusitis. Med Sci Monit 2019; 25:150-156. [PMID: 30612135 PMCID: PMC6330841 DOI: 10.12659/msm.913295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Fractional exhaled nitric oxide (FeNO) participates in the local defense of the upper respiratory tract. Abnormal FeNO level is directly related to the occurrence of nasal diseases. However, the clinical value of FeNO in the upper airway is limited, which greatly impedes the diagnosis and treatment of nasal diseases. Here, we assessed the level of FeNO and evaluated the diagnostic accuracy of FeNO for chronic rhinosinusitis. Material/Methods We enrolled 35 patients with confirmed nasal inflammation and 30 healthy subjects from December 2016 and June 2017. The FeNO level was measured using a fractional exhaled nitric oxide detector. The level of FeNO in patients with different clinicopathological factors was compared. The diagnostic potential of FeNO for chronic rhinosinusitis was evaluated by receiver operating characteristic (ROC) curve analysis. Results FeNO level was significantly lower in patients with nasal inflammation than in healthy subjects (P<0.05). For nasal inflammation diagnosis, FeNO had the highest area under the curve (AUC) at 0.760, with a sensitivity of 93.30% and a specificity of 68.60%. FeNO level was significantly downregulated in chronic rhinosinusitis patients relative to chronic rhinitis patients (P<0.05). FeNO had a good ability to discriminate between chronic rhinosinusitis patients and chronic rhinitis patients, with higher AUC, sensitivity, and specificity of 0.760, 93.30%, and 68.60%, respectively. However, FeNO levels were not significantly different between different histological types of chronic rhinosinusitis (P>0.05). Conclusions Our results show that FeNO is a useful marker for discriminating chronic rhinosinusitis, and has potential to provide valuable information in the early diagnosis of chronic rhinosinusitis.
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Affiliation(s)
- Junyi Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China (mainland).,Department of Otorhinolaryngology, Daqing Oilfield General Hospital, Daqing, Heilongjiang, China (mainland).,Department of Otolaryngology, Daqing First Hospital, Daqing, Heilongjiang, China (mainland)
| | - Yanan Sun
- Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Ming Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Chuanhui Sun
- Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Linli Tian
- Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
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25
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Schwartz PJ, Crotti L, George AL. Modifier genes for sudden cardiac death. Eur Heart J 2018; 39:3925-3931. [PMID: 30215713 PMCID: PMC6247660 DOI: 10.1093/eurheartj/ehy502] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/28/2018] [Indexed: 01/07/2023] Open
Abstract
Genetic conditions, even those associated with identical gene mutations, can present with variable clinical manifestations. One widely accepted explanation for this phenomenon is the existence of genetic factors capable of modifying the consequences of disease-causing mutations (modifier genes). Here, we address the concepts and principles by which genetic factors may be involved in modifying risk for cardiac arrhythmia, then discuss the current knowledge and interpretation of their contribution to clinical heterogeneity. We illustrate these concepts in the context of two important clinical conditions associated with risk for sudden cardiac death including a monogenic disorder (congenital long QT syndrome) in which the impact of modifier genes has been established, and a complex trait (life-threatening arrhythmias in acute myocardial infarction) for which the search for genetic modifiers of arrhythmic risk is more challenging. Advances in understanding the contribution of modifier genes to a higher or lower propensity towards sudden death should improve patient-specific risk stratification and be a major step towards precision medicine.
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Affiliation(s)
- Peter J Schwartz
- Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo, 22, Milan, Italy
- Corresponding author. Tel: +39 02 55000408, Fax: +39 02 55000411, ;
| | - Lia Crotti
- Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin and Laboratory of Cardiovascular Genetics, Via Pier Lombardo, 22, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48, Monza, Italy
- Istituto Auxologico Italiano, IRCCS, Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Piazzale Brescia 20, Milan, Italy
| | - Alfred L George
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Searle 8-510, East Superior Street, Chicago, IL, USA
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26
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Kocarnik JM, Richard M, Graff M, Haessler J, Bien S, Carlson C, Carty CL, Reiner AP, Avery CL, Ballantyne CM, LaCroix AZ, Assimes TL, Barbalic M, Pankratz N, Tang W, Tao R, Chen D, Talavera GA, Daviglus ML, Chirinos-Medina DA, Pereira R, Nishimura K, Bůžková P, Best LG, Ambite JL, Cheng I, Crawford DC, Hindorff LA, Fornage M, Heiss G, North KE, Haiman CA, Peters U, Le Marchand L, Kooperberg C. Discovery, fine-mapping, and conditional analyses of genetic variants associated with C-reactive protein in multiethnic populations using the Metabochip in the Population Architecture using Genomics and Epidemiology (PAGE) study. Hum Mol Genet 2018; 27:2940-2953. [PMID: 29878111 PMCID: PMC6077792 DOI: 10.1093/hmg/ddy211] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/02/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022] Open
Abstract
C-reactive protein (CRP) is a circulating biomarker indicative of systemic inflammation. We aimed to evaluate genetic associations with CRP levels among non-European-ancestry populations through discovery, fine-mapping and conditional analyses. A total of 30 503 non-European-ancestry participants from 6 studies participating in the Population Architecture using Genomics and Epidemiology study had serum high-sensitivity CRP measurements and ∼200 000 single nucleotide polymorphisms (SNPs) genotyped on the Metabochip. We evaluated the association between each SNP and log-transformed CRP levels using multivariate linear regression, with additive genetic models adjusted for age, sex, the first four principal components of genetic ancestry, and study-specific factors. Differential linkage disequilibrium patterns between race/ethnicity groups were used to fine-map regions associated with CRP levels. Conditional analyses evaluated for multiple independent signals within genetic regions. One hundred and sixty-three unique variants in 12 loci in overall or race/ethnicity-stratified Metabochip-wide scans reached a Bonferroni-corrected P-value <2.5E-7. Three loci have no (HACL1, OLFML2B) or only limited (PLA2G6) previous associations with CRP levels. Six loci had different top hits in race/ethnicity-specific versus overall analyses. Fine-mapping refined the signal in six loci, particularly in HNF1A. Conditional analyses provided evidence for secondary signals in LEPR, IL1RN and HNF1A, and for multiple independent signals in CRP and APOE. We identified novel variants and loci associated with CRP levels, generalized known CRP associations to a multiethnic study population, refined association signals at several loci and found evidence for multiple independent signals at several well-known loci. This study demonstrates the benefit of conducting inclusive genetic association studies in large multiethnic populations.
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Affiliation(s)
- Jonathan M Kocarnik
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
| | - Melissa Richard
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center, Houston, TX, USA
| | - Misa Graff
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Jeffrey Haessler
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stephanie Bien
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Chris Carlson
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Alexander P Reiner
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Christy L Avery
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Christie M Ballantyne
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Andrea Z LaCroix
- Department of Epidemiology, University of San Diego, San Diego, CA, USA
| | | | - Maja Barbalic
- Division of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas, Houston, TX, USA
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Weihong Tang
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Ran Tao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dongquan Chen
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gregory A Talavera
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, IL, USA
| | - Diana A Chirinos-Medina
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rocio Pereira
- Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katie Nishimura
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Petra Bůžková
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Lyle G Best
- Missouri Breaks Industries Research, Inc., Eagle Butte, SD, USA
| | - José Luis Ambite
- Information Sciences Institute, University of Southern California, Marina del Rey, CA, USA
| | - Iona Cheng
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Dana C Crawford
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center, Houston, TX, USA
- Human Genetics Center, School of Public Health, The University of Texas Health Science Center, Houston, TX, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Kari E North
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ulrike Peters
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Charles Kooperberg
- Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Roden DM, Glazer AM, Kroncke B. Arrhythmia genetics: Not dark and lite, but 50 shades of gray. Heart Rhythm 2018; 15:1231-1232. [PMID: 29709575 DOI: 10.1016/j.hrthm.2018.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Dan M Roden
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Andrew M Glazer
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brett Kroncke
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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28
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The role of genetics in primary ventricular fibrillation, inherited channelopathies and cardiomyopathies. Int J Cardiol 2018; 237:45-48. [PMID: 28532586 DOI: 10.1016/j.ijcard.2017.03.119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 03/22/2017] [Indexed: 11/24/2022]
Abstract
Sudden cardiac death (SCD) has a strong familial component; however, our understanding of its genetic basis varies significantly according to the underlying causes. When coronary artery disease is involved, the predisposing genetic background is complex and despite some interesting findings it remains largely unknown. Quite different is the case of monogenic structural and non-structural heart diseases, in which a number of disease-causing genes have been established and are being used in clinical practice. As SCD can be the first clinical manifestation of inherited syndromes, in order to ascertain the cause of death, it is extremely important to include molecular autopsy among the standard post-mortem examinations. Indeed, molecular screening of the major disease-causing genes in the deceased person is often the only way to achieve a post-mortem diagnosis in channelopathies, which may prove crucial for the identification and management of at risk family members. Overall, these data, together with the inclusion in current guidelines of molecular screening for diagnosis and/or risk stratification of specific inherited cardiac diseases, exemplify how research on the genetic basis of SCD may be deeply translational, while the transition of genetic testing from the research to the diagnostic setting is already improving every-day clinical practice.
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Abstract
Nitric oxide (NO) signalling has pleiotropic roles in biology and a crucial function in cardiovascular homeostasis. Tremendous knowledge has been accumulated on the mechanisms of the nitric oxide synthase (NOS)-NO pathway, but how this highly reactive, free radical gas signals to specific targets for precise regulation of cardiovascular function remains the focus of much intense research. In this Review, we summarize the updated paradigms on NOS regulation, NO interaction with reactive oxidant species in specific subcellular compartments, and downstream effects of NO in target cardiovascular tissues, while emphasizing the latest developments of molecular tools and biomarkers to modulate and monitor NO production and bioavailability.
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Affiliation(s)
- Charlotte Farah
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC) and Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, UCL-FATH Tour Vésale 5th Floor, 52 Avenue Mounier B1.53.09, 1200 Brussels, Belgium
| | - Lauriane Y M Michel
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC) and Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, UCL-FATH Tour Vésale 5th Floor, 52 Avenue Mounier B1.53.09, 1200 Brussels, Belgium
| | - Jean-Luc Balligand
- Pole of Pharmacology and Therapeutics (FATH), Institut de Recherche Experimentale et Clinique (IREC) and Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, UCL-FATH Tour Vésale 5th Floor, 52 Avenue Mounier B1.53.09, 1200 Brussels, Belgium
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The genetic variation rs12143842 in NOS1AP increases idiopathic ventricular tachycardia risk in Chinese Han populations. Sci Rep 2017; 7:8356. [PMID: 28827735 PMCID: PMC5567283 DOI: 10.1038/s41598-017-08548-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 07/14/2017] [Indexed: 11/30/2022] Open
Abstract
Genome-wide association studies identified that the common T of rs12143842 in NOS1AP is associated with a QT/QTc interval in European populations. In this study, we test the association between the variation rs12143842 in NOS1AP and idiopathic ventricular tachycardia (IVT). A case-control association study examining rs12143842 was performed in two independent cohorts. The Northern cohort enrolled 277 IVT patients and 728 controls from a Chinese Gene ID population. The Central cohort enrolled 301 IVT patients and 803 matched controls. Genotyping was performed using high-resolution melt analysis. The minor T allele of the rs12143842 SNP was significantly associated with decreased IVT risk in the Northern cohort (adjusted P = 0.024, OR 0.71(0.52~0.96)), and this association was replicated in an independent Central Gene ID cohort (adjusted P = 0.029, OR 0.78 (0.62~0.97)). The association was more significant in the combined population (adjusted P = 0.001, OR 0.76 (0.64~0.90)). The P values for the genotypic association were significant for the dominant (P < 0.001) and additive (P = 0.001) models. The minor T allele for the SNP rs12143842 in NOS1AP is significantly associated with IVT. NOS1AP might be a novel gene affecting IVT, and further functional studies should be performed.
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Jabbari R, Glinge C, Jabbari J, Risgaard B, Winkel BG, Terkelsen CJ, Tilsted HH, Jensen LO, Hougaard M, Haunsø S, Engstrøm T, Albert CM, Tfelt-Hansen J. A Common Variant in SCN5A and the Risk of Ventricular Fibrillation Caused by First ST-Segment Elevation Myocardial Infarction. PLoS One 2017; 12:e0170193. [PMID: 28085969 PMCID: PMC5234807 DOI: 10.1371/journal.pone.0170193] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/02/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Several common genetic variants have been associated with either ventricular fibrillation (VF) or sudden cardiac death (SCD). However, replication efforts have been limited. Therefore, we aimed to analyze whether such variants may contribute to VF caused by first ST-elevation myocardial infarction (STEMI). METHODS We analyzed 27 single nucleotide polymorphisms (SNP) previously associated with SCD/VF in other cohorts, and examined whether these SNPs were associated with VF caused by first STEMI in the GEnetic causes of Ventricular Arrhythmias in patients with first ST-elevation Myocardial Infarction (GEVAMI) study on ethnical Danes. The GEVAMI study is a prospective case-control study involving 257 cases (STEMI with VF) and 537 controls (STEMI without VF). RESULTS Of the 27 candidate SNPs, one SNP (rs11720524) located in intron 1 of SCN5A which was previously associated with SCD was significantly associated with VF caused by first STEMI. The major C-allele of rs11720524 was present in 64% of the cases and the C/C genotype was significantly associated with VF with an odds ratio (OR) of 1.87 (95% CI: 1.12-3.12; P = 0.017). After controlling for clinical differences between cases and controls such as age, sex, family history of sudden death, alcohol consumption, previous atrial fibrillation, statin use, angina, culprit artery, and thrombolysis in myocardial infarction (TIMI) flow, the C/C genotype of rs11720524 was still significantly associated with VF with an OR of 1.9 (95% CI: 1.05-3.43; P = 0.032). Marginal associations with VF were also found for rs9388451 in HEY2 gene. The CC genotype showed an insignificant risk for VF with OR = 1.50 (95% CI: 0.96-2.40; P = 0.070). CONCLUSION One common intronic variant in SCN5A suggested an association with VF caused by first STEMI. Further studies into the functional abnormalities associated with the noncoding variant in SCN5A may lead to important insights into predisposition to VF during STEMI.
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Affiliation(s)
- Reza Jabbari
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- * E-mail:
| | - Charlotte Glinge
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Javad Jabbari
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Bjarke Risgaard
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Bo Gregers Winkel
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | - Mikkel Hougaard
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Stig Haunsø
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Laboratory of Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Engstrøm
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christine M. Albert
- Center for Arrhythmia Prevention, Division of Preventive Medicine, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jacob Tfelt-Hansen
- Heart Center, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Maheshwari A, Norby FL, Soliman EZ, Adabag S, Whitsel EA, Alonso A, Chen LY. Low Heart Rate Variability in a 2-Minute Electrocardiogram Recording Is Associated with an Increased Risk of Sudden Cardiac Death in the General Population: The Atherosclerosis Risk in Communities Study. PLoS One 2016; 11:e0161648. [PMID: 27551828 PMCID: PMC4995012 DOI: 10.1371/journal.pone.0161648] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 08/09/2016] [Indexed: 12/19/2022] Open
Abstract
Low heart rate variability (HRV) has been linked to increased total mortality in the general population; however, the relationship between low HRV and sudden cardiac death (SCD) is less well-characterized. The goal of this study was to evaluate the relationship between low HRV and SCD in a community-based cohort. Our cohort consisted of 12,543 participants from the Atherosclerosis Risk in Communities (ARIC) study. HRV measures were derived from 2-minute electrocardiogram recordings obtained during the baseline exam (1987-89). Time domain measurements included the standard deviation of all normal RR intervals (SDNN) and the root mean squared successive difference (r-MSSD). Frequency domain measurements included low frequency power (LF) and high frequency (HF) power. During a median follow-up of 13 years, 215 SCDs were identified from physician adjudication of all coronary heart disease deaths through 2001. In multivariable adjusted Cox proportional hazards models, each standard deviation decrement in SDNN, LF, and HF were associated with 24%, 27% and 16% increase in SCD risk, respectively. Low HRV is independently associated with increased risk of SCD in the general population.
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Affiliation(s)
- Ankit Maheshwari
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Faye L. Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Elsayed Z. Soliman
- Epidemiological Cardiology Research Center (EPICARE), Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Selcuk Adabag
- Division of Cardiology, Veteran Affairs Medical Center, Minneapolis, Minnesota, United States of America
| | - Eric A. Whitsel
- Departments of Epidemiology and Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lin Y. Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
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Faragli A, Underwood K, Priori SG, Mazzanti A. Is There a Role for Genetics in the Prevention of Sudden Cardiac Death? J Cardiovasc Electrophysiol 2016; 27:1124-32. [PMID: 27279603 DOI: 10.1111/jce.13028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/27/2016] [Accepted: 05/24/2016] [Indexed: 12/16/2022]
Abstract
The identification of patients at risk for sudden cardiac death (SCD) is fundamental for both acquired cardiovascular diseases (such as coronary artery diseases, CAD) and inherited arrhythmia syndromes (such as the long-QT syndrome, LQTS). Genetics may play a role in both situations, although the potential to exploit this information to reduce the burden of SCD varies among these two groups. Concerning acquired cardiovascular diseases, which affect most of the general population, preliminary data suggest an association between genetics and the risk of dying suddenly. The maximal utility, instead, is reached in inherited arrhythmia syndromes, where the discovery of monogenic diseases such as LQTS tracked the way for the first genotype-phenotype correlations. The aim of this review is to provide a general overview focusing on the current genetic knowledge and on the present and future applicability for prevention in these two populations at risk for SCD.
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Affiliation(s)
| | | | - Silvia G Priori
- Molecular Cardiology, IRCCS Salvatore Maugeri Foundation, Pavia, Italy. .,Department of Molecular Medicine, University of Pavia, Pavia, Italy.
| | - Andrea Mazzanti
- Molecular Cardiology, IRCCS Salvatore Maugeri Foundation, Pavia, Italy
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34
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Habecker BA, Anderson ME, Birren SJ, Fukuda K, Herring N, Hoover DB, Kanazawa H, Paterson DJ, Ripplinger CM. Molecular and cellular neurocardiology: development, and cellular and molecular adaptations to heart disease. J Physiol 2016; 594:3853-75. [PMID: 27060296 DOI: 10.1113/jp271840] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/15/2016] [Indexed: 12/12/2022] Open
Abstract
The nervous system and cardiovascular system develop in concert and are functionally interconnected in both health and disease. This white paper focuses on the cellular and molecular mechanisms that underlie neural-cardiac interactions during development, during normal physiological function in the mature system, and during pathological remodelling in cardiovascular disease. The content on each subject was contributed by experts, and we hope that this will provide a useful resource for newcomers to neurocardiology as well as aficionados.
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Affiliation(s)
- Beth A Habecker
- Department of Physiology and Pharmacology, Department of Medicine Division of Cardiovascular Medicine and Knight Cardiovascular Institute, Oregon Health and Science University, Portland, OR, 97239, USA
| | - Mark E Anderson
- Johns Hopkins Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Susan J Birren
- Department of Biology, Volen Center for Complex Systems, Brandeis University, Waltham, MA, 02453, USA
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, 35-Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Neil Herring
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK
| | - Donald B Hoover
- Department of Biomedical Sciences, Center of Excellence in Inflammation, Infectious Disease and Immunity, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN, 37614, USA
| | - Hideaki Kanazawa
- Department of Cardiology, Keio University School of Medicine, 35-Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - David J Paterson
- Burdon Sanderson Cardiac Science Centre, Department of Physiology, Anatomy and Genetics, University of Oxford, Parks Road, Oxford, OX1 3PT, UK
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35
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Goldman AM, Behr ER, Semsarian C, Bagnall RD, Sisodiya S, Cooper PN. Sudden unexpected death in epilepsy genetics: Molecular diagnostics and prevention. Epilepsia 2016; 57 Suppl 1:17-25. [PMID: 26749013 DOI: 10.1111/epi.13232] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 12/19/2022]
Abstract
Epidemiologic studies clearly document the public health burden of sudden unexpected death in epilepsy (SUDEP). Clinical and experimental studies have uncovered dynamic cardiorespiratory dysfunction, both interictally and at the time of sudden death due to epilepsy. Genetic analyses in humans and in model systems have facilitated our current molecular understanding of SUDEP. Many discoveries have been informed by progress in the field of sudden cardiac death and sudden infant death syndrome. It is becoming apparent that SUDEP genomic complexity parallels that of sudden cardiac death, and that there is a pauci1ty of analytically useful postmortem material. Because many challenges remain, future progress in SUDEP research, molecular diagnostics, and prevention rests in international, collaborative, and transdisciplinary dialogue in human and experimental translational research of sudden death.
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Affiliation(s)
- Alica M Goldman
- Department of Neurology, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Elijah R Behr
- Cardiac Research Centre, ICCS, St George's University of London, London, United Kingdom
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Richard D Bagnall
- Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Sanjay Sisodiya
- Institute of Neurology, University College London, London, United Kingdom
| | - Paul N Cooper
- Department of Neurology, Greater Manchester Neurosciences Centre, Salford, United Kingdom.,University of Manchester, Manchester, United Kingdom
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36
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Sugiyama K, Sasano T, Kurokawa J, Takahashi K, Okamura T, Kato N, Isobe M, Furukawa T. Oxidative Stress Induced Ventricular Arrhythmia and Impairment of Cardiac Function in Nos1ap Deleted Mice. Int Heart J 2016; 57:341-9. [PMID: 27170476 DOI: 10.1536/ihj.15-471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Genome-wide association study has identified that the genetic variations at NOS1AP (neuronal nitric oxide synthase-1 adaptor protein) were associated with QT interval and sudden cardiac death (SCD). However, the mechanism linking a genetic variant of NOS1AP and SCD is poorly understood. We used Nos1ap knockout mice (Nos1ap(-/-)) to determine the involvement of Nos1ap in SCD, paying special attention to oxidative stress.At baseline, a surface electrocardiogram (ECG) and ultrasound echocardiography (UCG) showed no difference between Nos1ap(-/-) and wild-type (WT) mice. Oxidative stress was induced by a single injection of doxorubicin (Dox, 25 mg/kg). After Dox injection, Nos1ap(-/-) showed significantly higher mortality than WT (93.3 versus 16.0% at day 14, P < 0.01). ECG showed significantly longer QTc in Nos1ap(-/-) than WT, and UCG revealed significant reduction of fractional shortening (%FS) only in Nos1ap(-/-) after Dox injection. Spontaneous ventricular tachyarrhythmias were documented by telemetry recording after Dox injection only in Nos1ap(-/-). Ex vivo optical mapping revealed that the action potential duration (APD)90 was prolonged at baseline in Nos1ap(-/-), and administration of Dox lengthened APD90 more in Nos1ap(-/-) than in WT. The expression of Bnp and the H2O2 level were higher in Nos1ap(-/-) after Dox injection. Nos1ap(-/-) showed a reduced amplitude of calcium transient in isolated cardiomyocytes after Dox injection. Administration of the antioxidant N-acetyl-L-cysteine significantly reduced mortality of Nos1ap(-/-) by Dox injection, accompanied by prevention of QT prolongation and a reduction in %FS.Although Nos1ap(-/-) mice have apparently normal hearts, oxidative stress evokes ventricular tachyarrhythmia and heart failure, which may cause sudden cardiac death.
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Affiliation(s)
- Koji Sugiyama
- Department of Bio-informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University
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37
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Circulating n-3 fatty acids and trans-fatty acids, PLA2G2A gene variation and sudden cardiac arrest. J Nutr Sci 2016; 5:e12. [PMID: 27313848 PMCID: PMC4791519 DOI: 10.1017/jns.2016.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/16/2015] [Accepted: 01/07/2016] [Indexed: 11/16/2022] Open
Abstract
Whether genetic factors influence the associations of fatty acids with the risk of sudden
cardiac arrest (SCA) is largely unknown. To investigate possible gene–fatty acid
interactions on SCA risk, we used a case-only approach and measured fatty acids in
erythrocyte samples from 1869 SCA cases in a population-based repository with genetic
data. We selected 191 SNP in ENCODE-identified regulatory regions of fifty-five candidate
genes in fatty acid metabolic pathways. Using linear regression and additive genetic
models, we investigated the association of the selected SNP with erythrocyte levels of
fatty acids, including DHA, EPA and trans-fatty acids among the SCA
cases. The assumption of no association in non-cases was supported by analysis of publicly
available datasets containing over 8000 samples. None of the SNP–fatty acid associations
tested among the cases reached statistical significance after correction for multiple
comparisons. One SNP, rs4654990 near PLA2G2A, with an allele frequency of
0·33, was nominally associated with lower levels of DHA and EPA and higher levels of
trans-fatty acids. The strongest association was with DHA levels
(exponentiated coefficient for one unit (1 % of total fatty acids), 0·90, 95 % CI 0·85,
0·97; P = 0·003), indicating that for subjects with a coded allele, the
OR of SCA associated with one unit higher DHA is about 90 % what it is for subjects with
one fewer coded allele. These findings suggest that the associations of circulating
n-3 and trans-fatty acids with SCA risk may be more
pronounced in carriers of the rs4654990 G allele.
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38
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Roden DM. Predicting drug-induced QT prolongation and torsades de pointes. J Physiol 2016; 594:2459-68. [PMID: 26660066 DOI: 10.1113/jp270526] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/03/2015] [Indexed: 12/16/2022] Open
Abstract
Drugs used to treat cardiovascular disease as well as those used in the treatment of multiple other conditions can occasionally produce exaggerated prolongation of the QT interval on the electrocardiogram and the morphologically distinctive polymorphic ventricular tachycardia ('torsades de pointes'). This syndrome of drug-induced long QT syndrome has moved from an interesting academic exercise to become a key element in the development of any new drug entity. The prevailing view, which has driven both clinical care and drug regulation, holds that cardiac repolarization represents a balance between inward currents (primarily through calcium and sodium channels) and outward currents (primarily through rapid and slowed delayed rectifier potassium channels) and that block of the rapid delayed rectifier (IKr ) is the primary mechanism whereby drugs prolong individual action potentials, manifest on the surface electrocardiogram as QT interval prolongation. Such marked action potential prolongation in individual cardiac cells, in turn, is accompanied by arrhythmogenic afterdepolarizations thought to trigger torsades de pointes. This review describes the evidence in support of this construct, and describes the way in which clinical and whole heart experiments have informed molecular mechanisms and vice versa. New data that challenge these views and that may, as a result, lead to new clinical care and drug screening paradigms, are discussed.
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Affiliation(s)
- Dan M Roden
- Vanderbilt University, Nashville, TN, 37232, USA
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39
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EARLE NIKKI, INGLES JODIE, BAGNALL RICHARDD, GRAY BELINDA, CRAWFORD JACKIE, SMITH WARREN, SHELLING ANDREWN, LOVE DONALDR, SEMSARIAN CHRIS, SKINNER JONATHANR. NOS1AP
Polymorphisms Modify QTc Interval Duration But Not Cardiac Arrest Risk in Hypertrophic Cardiomyopathy. J Cardiovasc Electrophysiol 2015; 26:1346-51. [DOI: 10.1111/jce.12827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/03/2015] [Accepted: 08/25/2015] [Indexed: 02/05/2023]
Affiliation(s)
- NIKKI EARLE
- Department of Medicine, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - JODIE INGLES
- Sydney Medical School; University of Sydney; Sydney
- Agnes Ginges Centre for Molecular Cardiology; Centenary Institute; Camperdown Australia
- Department of Cardiology; Royal Prince Alfred Hospital; Sydney
| | - RICHARD D. BAGNALL
- Sydney Medical School; University of Sydney; Sydney
- Agnes Ginges Centre for Molecular Cardiology; Centenary Institute; Camperdown Australia
| | - BELINDA GRAY
- Sydney Medical School; University of Sydney; Sydney
- Agnes Ginges Centre for Molecular Cardiology; Centenary Institute; Camperdown Australia
- Department of Cardiology; Royal Prince Alfred Hospital; Sydney
| | - JACKIE CRAWFORD
- Greenlane Paediatric and Congenital Cardiac Services; Starship Childrens Hospital; Auckland New Zealand
| | - WARREN SMITH
- Greenlane Cardiovascular Services; Auckland City Hospital; Auckland New Zealand
| | - ANDREW N. SHELLING
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - DONALD R. LOVE
- Diagnostic Genetics, LabPlus; Auckland City Hospital; Auckland New Zealand
| | - CHRIS SEMSARIAN
- Sydney Medical School; University of Sydney; Sydney
- Agnes Ginges Centre for Molecular Cardiology; Centenary Institute; Camperdown Australia
- Department of Cardiology; Royal Prince Alfred Hospital; Sydney
| | - JONATHAN R. SKINNER
- Greenlane Paediatric and Congenital Cardiac Services; Starship Childrens Hospital; Auckland New Zealand
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40
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Affiliation(s)
- Gordon F Tomaselli
- From the Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
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Increase of Heart Rate and QTc by Amitriptyline, But Not by Venlafaxine, Is Correlated to Serum Concentration. J Clin Psychopharmacol 2015; 35:460-3. [PMID: 26035054 DOI: 10.1097/jcp.0000000000000336] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Electrocardiographic pathologies are a common problem during antidepressant treatment. The authors investigated the association of serum concentrations of antidepressants and heart rate, QT, and QTc. Polymorphisms of NOS1AP (nitric oxide synthase 1 adaptor protein) rs10494366 and rs12143842 as potential influence factors also were considered. In the amitriptyline sample (n = 59), significant Spearman ρ correlations were found between serum concentration and QTc (r = 0.333, P = 0.010), as well as heart rate (r = 0.407, P = 0.001). Patients with a serum concentration greater than the therapeutic range (>200 ng/mL) exhibit significantly higher heart rates (87.0 ± 13.3 vs 80.0 ± 13.9, U test P = 0.011) and higher QTc values (443.8 ± 28.8 vs 427.9 ± 20.6, U test P = 0.022). Excluding the 26 patients with a serum concentration greater than the therapeutic range, patients with rs12143842 risk alleles exhibit higher heart rates and as a trend lower QT intervals with no difference in QTc. In the venlafaxine sample (n = 81), no significant association between serum concentration and heart rate, QT, or QTc was revealed. In summary, the risk for relevant electrocardiographic alterations induced by tricyclic antidepressants, such as amitriptyline, is dependent on serum concentrations. NOS1AP polymorphisms may be a genetic vulnerability factor.
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Pharmacogenetic effects of 'candidate gene complexes' on stroke in the GenHAT study. Pharmacogenet Genomics 2015; 24:556-63. [PMID: 25171760 DOI: 10.1097/fpc.0000000000000088] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether there is a genotype-by-treatment interaction in patients experiencing stroke and treated with one of three antihypertensive drugs, that is chlorthalidone, amlodipine, or lisinopril. PARTICIPANTS AND METHODS A population of 436 African Americans and 539 whites who had experienced stroke in the GenHAT study were genotyped for 768 single nucleotide polymorphisms (SNPs) in 280 candidate genes. To detect a genotype-by-treatment interaction, we used the Pearson's χ-test to assess whether the genotype frequencies differed at the single SNP level for the three drug treatment groups. From these single SNP analyses, we derived a summary statistic for the degree of association at the gene and gene complex levels. This was done by grouping SNPs using information on gene locations and defining gene complexes on the basis of protein-protein interactions. To assess the statistical significance of the observed test statistic, we derived an empirical P-value by simulating data under the null hypothesis. RESULTS We found that, in patients who have experienced stroke, there is a significant genetic difference between hypertension drug treatment groups. In African Americans, SNP rs12143842 showed a significant association (P<0.001) with drug treatment. At the gene level, HNRNPA1P4 and NOS1AP in African Americans and PRICKLE1 and NINJ2 in non-Hispanic whites were significantly associated (P<0.01) with drug treatment, whereas none of the gene complexes tested showed significance. CONCLUSION On the basis of the genetic differences between drug treatment groups, we conclude that there may be an interaction between certain genotypes and antihypertensive treatment in stroke patients. This needs to be replicated in other studies.
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Abstract
BACKGROUND Genome-wide association studies and candidate-gene based approaches have identified multiple common variants associated with increased risk of sudden cardiac death (SCD). However, the independent contribution of these individual loci to disease risk is modest. OBJECTIVE To investigate the cumulative effects of genetic variants previously associated with SCD risk. METHODS A total of 966 SCD cases from the Oregon-Sudden Unexpected Death Study and 1,926 coronary artery disease controls from the Wellcome Trust Case-Control Consortium were investigated. We generated genetic risk scores (GRS) for each trait composed of variants previously associated with SCD or with abnormalities in specific electrocardiographic traits such as QRS duration, QTc interval and heart rate. GRSs were calculated using a weighted approach based on the number of risk alleles weighted by the beta coefficients derived from the original studies. We also compared the highest and lowest quintiles for the GRS composed of SCD SNPs. RESULTS Increased cumulative risk was observed for a GRS composed of 14 SCD-SNPs (OR=1.17 [1.05-1.29], P = 0.002). The risk for SCD was 1.5 fold higher in the highest quintile when compared to the lowest quintile (OR = 1.46[1.11-1.92]). We did not observe significant associations with SCD for SNPs that determine electrocardiographic traits. CONCLUSIONS A modest but significant effect on SCD risk was identified for a GRS composed of 14 previously associated SCD SNPs. While next generation sequencing methodology will continue to identify additional novel variants, these findings represent proof of concept for the additive effects of gene variants on SCD risk.
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Lu CJ, Hao G, Nikiforova N, Larsen HE, Liu K, Crabtree MJ, Li D, Herring N, Paterson DJ. CAPON modulates neuronal calcium handling and cardiac sympathetic neurotransmission during dysautonomia in hypertension. Hypertension 2015; 65:1288-1297. [PMID: 25916729 DOI: 10.1161/hypertensionaha.115.05290] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/03/2015] [Indexed: 02/07/2023]
Abstract
Genome-wide association studies implicate a variant in the neuronal nitric oxide synthase adaptor protein (CAPON) in electrocardiographic QT variation and sudden cardiac death. Interestingly, nitric oxide generated by neuronal NO synthase-1 reduces norepinephrine release; however, this pathway is downregulated in animal models of cardiovascular disease. Because sympathetic hyperactivity can trigger arrhythmia, is this neural phenotype linked to CAPON dysregulation? We hypothesized that CAPON resides in cardiac sympathetic neurons and is a part of the prediseased neuronal phenotype that modulates calcium handling and neurotransmission in dysautonomia. CAPON expression was significantly reduced in the stellate ganglia of spontaneously hypertensive rats before the development of hypertension compared with age-matched Wistar-Kyoto rats. The neuronal calcium current (ICa; n=8) and intracellular calcium transient ([Ca(2+)]i; n=16) were significantly larger in the spontaneously hypertensive rat than in Wistar-Kyoto rat (P<0.05). A novel noradrenergic specific vector (Ad.PRSx8-mCherry/CAPON) significantly upregulated CAPON expression, NO synthase-1 activity, and cGMP in spontaneously hypertensive rat neurons without altering NO synthase-1 levels. Neuronal ICa and [Ca(2+)]i were significantly reduced after CAPON transduction compared with the empty vector. In addition, Ad.PRSx8-mCherry/CAPON also reduced (3)H-norepinephrine release from spontaneously hypertensive rat atria (n=7). NO synthase-1 inhibition (AAAN, 10 μmol/L; n=6) reversed these effects compared with the empty virus alone. In conclusion, targeted upregulation of CAPON decreases cardiac sympathetic hyperactivity. Moreover, dysregulation of this adaptor protein in sympathetic neurons might further amplify the negative cardiac electrophysiological properties seen with CAPON mutations.
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Affiliation(s)
- Chieh-Ju Lu
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - Guoliang Hao
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - Natalia Nikiforova
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - Hege E Larsen
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - Kun Liu
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - Mark J Crabtree
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - Dan Li
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - Neil Herring
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
| | - David J Paterson
- Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre (C.-J.L., G.H., N.N., H.E.L., K.L., D.L., N.H., D.J.P.) and Radcliffe Department of Medicine, John Radcliffe Hospital (M.J.C.), University of Oxford, Oxford, United Kingdom
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Chan KE, Newton-Cheh C, Gusella JF, Maddux FW. Heritability of Risk for Sudden Cardiac Arrest in ESRD. J Am Soc Nephrol 2015; 26:2815-20. [PMID: 25882830 DOI: 10.1681/asn.2014090881] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/28/2015] [Indexed: 11/03/2022] Open
Abstract
Patients on dialysis are 20 times more likely to have a cardiac arrest compared with the general population. We considered whether inherited factors associate with cardiac arrest among patients on dialysis. From a sample of 647,457 patients on chronic dialysis, we identified 5117 pairs of patients who came from the same family. These patients were each matched to a control subject from the same population. McNemar's tests were used to compare the risk of cardiac arrest between the familial related and unrelated pairs. Genetically related family members who did not cohabitate had an odds ratio of 1.88 (95% confidence interval [95% CI], 1.25 to 2.84) for cardiac arrest compared with their phenotypically matched unrelated controls. Genetically related family members who lived together in the same environment had an odds ratio of 1.66 (95% CI, 1.20 to 2.28). Spouses, who are genetically unrelated but live together in the same environment, had an odds ratio of 0.95 (95% CI, 0.60 to 1.59) for cardiac arrest. The risk of cardiac arrest in patients on dialysis may be attributable to inherited factors. Additional studies are needed to identify such candidate genes that modify cardiovascular risk in ESRD.
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Affiliation(s)
- Kevin E Chan
- Nephrology Division, Clinical Research Division, Fresenius Medical Care North America, Waltham, Massachusetts
| | | | - James F Gusella
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts; and
| | - Franklin W Maddux
- Clinical Research Division, Fresenius Medical Care North America, Waltham, Massachusetts
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Earle NJ, Poppe KK, Pilbrow AP, Cameron VA, Troughton RW, Skinner JR, Love DR, Shelling AN, Whalley GA, Ellis CJ, Richards AM, Doughty RN. Genetic markers of repolarization and arrhythmic events after acute coronary syndromes. Am Heart J 2015; 169:579-86.e3. [PMID: 25819866 DOI: 10.1016/j.ahj.2014.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/21/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is a genetic contribution to the risk of ventricular arrhythmias in survivors of acute coronary syndromes (ACS). We wished to explore the role of 33 candidate single nucleotide polymorphisms (SNPs) in prolonged repolarization and sudden death in patients surviving ACS. METHODS A total of 2,139 patients (1680 white ethnicity) surviving an admission for ACS were enrolled in the prospective Coronary Disease Cohort Study. Extensive clinical, echocardiographic, and neurohormonal data were collected for 12 months, and clinical events were recorded for a median of 5 years. Each SNP was assessed for association with sudden cardiac death (SCD)/cardiac arrest (CA) and prolonged repolarization at 3 time-points: index admission, 1 month, and 12 months postdischarge. RESULTS One hundred six SCD/CA events occurred during follow-up (6.3%). Three SNPs from 3 genes (rs17779747 [KCNJ2], rs876188 [C14orf64], rs3864180 [GPC5]) were significantly associated with SCD/CA in multivariable models (after correction for multiple testing); the minor allele of rs17779747 with a decreased risk (hazard ratio [HR] 0.68 per copy of the minor allele, 95% CI 0.50-0.92, P = .012), and rs876188 and rs386418 with an increased risk (HR 1.52 [95% CI 1.10-2.09, P = .011] and HR 1.34 [95% CI 1.04-1.82, P = .023], respectively). At 12 months postdischarge, rs10494366 and rs12143842 (NOS1AP) were significant predictors of prolonged repolarization (HR 1.32 [95% CI 1.04-1.67, P = .022] and HR 1.30 [95% CI 1.01-1.66, P = .038], respectively), but not at earlier time-points. CONCLUSION Three SNPs were associated with SCD/CA. Repolarization time was associated with variation in the NOS1AP gene. This study demonstrates a possible role for SNPs in risk stratification for arrhythmic events after ACS.
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Affiliation(s)
- N J Earle
- Department of Medicine, University of Auckland, Auckland, New Zealand.
| | - K K Poppe
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - A P Pilbrow
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand
| | - V A Cameron
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand
| | - R W Troughton
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand
| | - J R Skinner
- Greenlane Pediatric and Congenital Cardiac Services, Starship Childrens Hospital, Auckland, New Zealand
| | - D R Love
- Diagnostic Genetics, LabPlus, Auckland City Hospital, Auckland, New Zealand
| | - A N Shelling
- Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
| | - G A Whalley
- Faculty of Social and Health Sciences, Unitec, Auckland, New Zealand
| | - C J Ellis
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - A M Richards
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand; Cardiovascular Research Institute, National University of Singapore, Singapore
| | - R N Doughty
- Department of Medicine, University of Auckland, Auckland, New Zealand
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Rezuş C, Moga VD, Ouatu A, Floria M. QT interval variations and mortality risk: is there any relationship? Anatol J Cardiol 2015; 15:255-8. [PMID: 25880179 PMCID: PMC5337065 DOI: 10.5152/akd.2015.5875] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 01/24/2023] Open
Abstract
Abnormal prolongation and shortening of the electrocardiographic QT interval duration, which occur in the hereditary forms of long and short QT syndromes, are associated with an increased risk of ventricular arrhythmias and sudden cardiac death. Even within the normal range, these altered durations are associated with an increased mortality risk in the general population. While extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, the precise dose-response relationship between the QT interval and cardiovascular disease mortality is still unknown. This paper describes the need for more standardized methods for measuring and reporting the QT interval and the need for more precise assessments of the risk associated with QT interval variation.
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Affiliation(s)
- Ciprian Rezuş
- III Medical Clinic of "Sf. Spiridon" University Hospital, and "Grigore T. Popa" University of Medicine and Pharmacy; Iaşi-Romania.
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Huang J, Wang X, Hao B, Chen Y, Liu H, Quan L, Tang D, Sheng L, Li M, Huang E, Liu C, Luo B. Genetic variants in KCNE1, KCNQ1, and NOS1AP in sudden unexplained death during daily activities in Chinese Han population. J Forensic Sci 2015; 60:351-6. [PMID: 25639344 DOI: 10.1111/1556-4029.12687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 04/02/2014] [Accepted: 04/15/2014] [Indexed: 11/29/2022]
Abstract
Fifty-six sudden unexplained death (SUD) cases were collected from Chinese Han population, which occurred during daily activities and were autopsy negative in comprehensive postmortem autopsy. The coding exons of potassium channel genes KCNE1, KCNQ1, and nitric oxide synthase gene NOS1AP were sequenced. A synonymous mutation, KCNE1 F54F T>C was identified in 2 SUD cases, which was absent in the control subjects. Neither genotype nor allele frequencies of KCNE1 and KCNQ1 exhibited a significant difference between the SUD and control group. In contrast, the allele frequency (p = 2.7 × 10(-10)) and genotype frequency (p = 5.9 × 10(-7)) of rs3751284, and the genotype frequency (p = 2.9 × 10(-2)) of rs348624 in NOS1AP of SUD were significantly different from that of controls (p < 0.05). Our study suggested that rs3751284 and rs348624 might be susceptibility loci for SUD during daily activities. Larger sample sizes and further molecular studies are needed to confirm or exclude an effect of the NOS1AP SNPs on SUD risk.
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Affiliation(s)
- Jinglu Huang
- Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
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Waks JW, Soliman EZ, Henrikson CA, Sotoodehnia N, Han L, Agarwal SK, Arking DE, Siscovick DS, Solomon SD, Post WS, Josephson ME, Coresh J, Tereshchenko LG. Beat-to-beat spatiotemporal variability in the T vector is associated with sudden cardiac death in participants without left ventricular hypertrophy: the Atherosclerosis Risk in Communities (ARIC) Study. J Am Heart Assoc 2015; 4:e001357. [PMID: 25600143 PMCID: PMC4330061 DOI: 10.1161/jaha.114.001357] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Despite advances in prevention and treatment of cardiovascular disease, sudden cardiac death (SCD) remains a clinical challenge. Risk stratification in the general population is needed. Methods and Results Beat‐to‐beat spatiotemporal variability in the T vector was measured as the mean angle between consecutive T‐wave vectors (mean TT′ angle) on standard 12‐lead ECGs in 14 024 participants in the Atherosclerosis Risk in Communities (ARIC) study. Subjects with left ventricular hypertrophy, atrial arrhythmias, frequent ectopy, ventricular pacing, or QRS duration ≥120 ms were excluded. The mean spatial TT′ angle was 5.21±3.55°. During a median of 14 years of follow‐up, 235 SCDs occurred (1.24 per 1000 person‐years). After adjustment for demographics, coronary heart disease risk factors, and known ECG markers for SCD, mean TT′ angle was independently associated with SCD (hazard ratio 1.089; 95% CI 1.044 to 1.137; P<0.0001). A mean TT′ angle >90th percentile (>9.57°) was associated with a 2‐fold increase in the hazard for SCD (hazard ratio 2.01; 95% CI 1.28 to 3.16; P=0.002). In a subgroup of patients with T‐vector amplitude ≥0.2 mV, the association with SCD was almost twice as strong (hazard ratio 3.92; 95% CI 1.91 to 8.05; P<0.0001). A significant interaction between mean TT′ angle and age was found: TT′ angle was associated with SCD in participants aged <55 years (hazard ratio 1.096; 95% CI 0.043 to 1.152; P<0.0001) but not in participants aged ≥55 years (Pinteraction=0.009). Conclusions In a large, prospective, community‐based cohort of left ventricular hypertrophy–free participants, increased beat‐to‐beat spatiotemporal variability in the T vector, as assessed by increasing TT′ angle, was associated with SCD.
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Affiliation(s)
- Jonathan W Waks
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (J.W.W., M.E.J.)
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences and Department of Medicine, Cardiology Section, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.)
| | - Charles A Henrikson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR (C.A.H., L.G.T.)
| | | | - Lichy Han
- Whitening School of Engineering, Johns Hopkins University, Baltimore, MD (L.H.)
| | - Sunil K Agarwal
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Public Health, Baltimore, MD (S.K.A., J.C.)
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (D.E.A.)
| | - David S Siscovick
- University of Washington, Seattle, WA (N.S., D.S.S.) The New York Academy of Medicine, New York, NY (D.S.S.)
| | - Scott D Solomon
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.D.S.)
| | - Wendy S Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P., L.G.T.)
| | - Mark E Josephson
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (J.W.W., M.E.J.)
| | - Josef Coresh
- Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Public Health, Baltimore, MD (S.K.A., J.C.)
| | - Larisa G Tereshchenko
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR (C.A.H., L.G.T.) Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P., L.G.T.)
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50
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Tereshchenko LG, Henrikson CA, Sotoodehnia N, Arking DE, Agarwal SK, Siscovick DS, Post WS, Solomon SD, Coresh J, Josephson ME, Soliman EZ. Electrocardiographic deep terminal negativity of the P wave in V(1) and risk of sudden cardiac death: the Atherosclerosis Risk in Communities (ARIC) study. J Am Heart Assoc 2014; 3:e001387. [PMID: 25416036 PMCID: PMC4338733 DOI: 10.1161/jaha.114.001387] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Identifying individuals at risk for sudden cardiac death (SCD) is of critical importance. Electrocardiographic (ECG) deep terminal negativity of P wave in V1 (DTNPV1), a marker of left atrial abnormality, has been associated with increased risk of all‐cause and cardiovascular mortality. We hypothesized that DTNPV1 is associated with increased risk of sudden cardiac death (SCD). Methods and Results This analysis included 15 375 participants (54.1±5.8 years, 45% men, 73% whites) from the Atherosclerosis Risk in Communities (ARIC) study. DTNPV1 was defined from the resting 12‐lead ECG as presence of biphasic P wave (positive/negative) in V1 with the amplitude of the terminal negative phase >100 μV, or one small box on ECG scale. After a median of 14 years of follow‐up, 311 cases of SCD occurred. In unadjusted Cox regression, DTNPV1 was associated with an 8‐fold increased risk of SCD (HR 8.21; [95%CI 5.27 to 12.79]). Stratified by race and study center, and adjusted for age, sex, coronary heart disease (CHD), and ECG risk factors, as well as atrial fibrillation (AF), stroke, CHD, and heart failure (HF) as time‐updated variables, the risk of SCD associated with DTNPV1 remained significant (2.49, [1.51–4.10]). DTNPV1 improved reclassification: additional 3.4% of individuals were appropriately reclassified into a higher SCD risk group, as compared with traditional CHD risk factors alone. In fully adjusted models DTNPV1 was associated with increased risk of non‐fatal events: AF (5.02[3.23–7.80]), CHD (2.24[1.43–3.53]), HF (1.90[1.19–3.04]), and trended towards increased risk of stroke (1.88[0.99–3.57]). Conclusion DTNPV1 is predictive of SCD suggesting its potential utility in risk stratification in the general population.
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Affiliation(s)
- Larisa G Tereshchenko
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (L.G.T., W.S.P.) Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR (L.G.T., C.A.H.)
| | - Charles A Henrikson
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR (L.G.T., C.A.H.)
| | | | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (D.E.A.)
| | - Sunil K Agarwal
- Department of Epidemiology, Internal Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Public Health, Baltimore, MD (S.K.A., J.C.)
| | - David S Siscovick
- University of Washington, Seattle, WA (N.S., D.S.S.) The New York Academy of Medicine, New York, NY (D.S.S.)
| | - Wendy S Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (L.G.T., W.S.P.)
| | - Scott D Solomon
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.D.S.)
| | - Josef Coresh
- Department of Epidemiology, Internal Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins School of Public Health, Baltimore, MD (S.K.A., J.C.)
| | - Mark E Josephson
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (M.E.J.)
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences and Department of Medicine, Cardiology Section, Wake Forest School of Medicine, Winston Salem, NC (E.Z.S.)
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