Key result
The adenosine A2A receptor 1083 T > C polymorphism was not associated with head-up tilt test positivity, though the CC genotype was associated with lower low-frequency power during early tilt (P=0.01).
Why the study?
Is the adenosine A2A receptor 1083 T > C polymorphism associated with head-up tilt test positivity in patients with vasovagal syncope?
Observational (n=432)
Is the adenosine A2A receptor 1083 T > C polymorphism associated with head-up tilt test positivity in patients with vasovagal syncope?
The adenosine A2A receptor 1083 T > C polymorphism does not predict head-up tilt test positivity in patients with vasovagal syncope, though the CC genotype may be associated with lower sympathetic activity during the test.
No association with tilt positivity in vasovagal syncope; hypothesis-generating for autonomic modulation by CC genotype.
BACKGROUND: Adenosine may play a role in the pathogenesis of vasovagal syncope (VVS). The aim of the study was to evaluate the adenosine A(2A) receptor gene 1083 T > C polymorphism in patients with syncope and its possible association with results of head-up tilt test (HUT). METHODS: Three hundred and forty-seven consecutive patients (mean age 47.3 ± 18.5 years, 132 men, 215 women) with one or more syncopal episodes underwent HUT as part of standardized diagnostic evaluation. HUT was positive in 207 patients (75 males, mean age 44.7 ± 18.6 years) and negative in 140 patients (58 males, mean age 48.17 ± 18.8 years). One thousand and eighty-three T > C single nucleotide polymorphism in the adenosine A(2A) receptor gene (rs5751876) was evaluated in 347 patients with syncope and in 85 subjects without history of syncope (54 men, mean age 41.7 ± 16.3). RESULTS: Adenosine A(2A) receptor 1083 T > C polymorphism was not associated with the positivity of HUT. Blood pressure and heart rate response to tilting was similar in all genotypes. Low frequency (LF) power was significantly lower in CC genotype compared to CT genotype in early phase of tilt (log LF 2.69 ± 0.61 vs 3.20 ± 0.60; P = 0.01) and at the time of syncope (log LF 2.60 ± 0.63 vs 2.77 ± 0.48; P = 0.04). CONCLUSIONS: Adenosine A(2A) receptor 1083 T > C polymorphism is not associated with the positivity of HUT and its proposed role in predisposition to VVS was not confirmed. CC genotype may be associated with lower sympathetic activity during HUT.
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Mitro et al. (2015) conducted an observational in Vasovagal syncope (n=432). Adenosine A2A receptor 1083 T > C polymorphism (rs5751876) vs. Different genotypes / subjects without history of syncope was evaluated on Positivity of head-up tilt test (HUT). The adenosine A2A receptor 1083 T > C polymorphism was not associated with head-up tilt test positivity, though the CC genotype was associated with lower low-frequency power during early tilt (P=0.01).
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