Polymorphisms of the Beta Adrenergic Receptor Predict Left Ventricular Remodeling Following Acute Myocardial Infarction
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Rhondalyn C. McLean , Glenn A. Hirsch , Lewis C. Becker , Laura Kasch-Semenza , Gary Gerstenblith , Steven P. Schulman
- چاپ و سال / کشور: 2011
Description
Purpose Prior studies demonstrate an association between specific beta-adrenergic receptor (â-AR) polymorphisms and clinical outcomes in patients with chronic heart failure and following acute coronary syndromes. The underlying mechanism may be due to differences in left ventricular remodeling. This study was undertaken to explore the relationship between LV remodeling after myocardial infarction and polymorphisms in the cardiac â1-AR and â2-AR genes. Methods After first ST-segment elevation myocardial infarction (STEMI), 122 patients on chronic â1 receptor antagonist therapy underwent baseline and 6-month LV volume evaluation. We assessed the relationships between changes in LV volumes and the polymorphisms in â1-AR, â1-Arg389Gly and â1-Ser49Gly, and in â2-AR, â2- Gly16Arg and â2-Gln27Glu. Results We found that patients homozygous for the â2- Glu27 variant were 5.2 times more likely to be in the group with the highest end systolic volume (ESV) progression (OR 5.2, 95%CI 1.4–19.0). They were also more likely to have the largest progression of end diastolic volume (EDV) and decrease in LVejection fraction (LVEF). For those with baseline LV dysfunction, being homozygous for Arg at amino acid position 389 in â1-AR was associated with decreases in ESV (.46 mL, CI .3.1, -88) and EDV (.40 mL, CI .1.1, .79) and an increase in LVEF (11%, CI 0.3, 22). Conclusion We found that polymorphisms of the â1-AR and â2-AR genes are associated with differential LV remodeling in patients treated with a â1 receptor antagonist following STEMI.
Cardiovasc Drugs Ther (2011) 25:251–258 Published online: 28 May 2011
