Key result
In women with peripartum cardiomyopathy, the GNB3 TT genotype was associated with lower left ventricular ejection fraction at 12 months compared to the C allele (0.45 vs 0.56, P<0.001).
Why the study?
Is the GNB3 TT genotype associated with poorer myocardial recovery (lower LVEF) compared to the C allele in women with peripartum cardiomyopathy?
Cohort (n=97)
Is the GNB3 TT genotype associated with poorer myocardial recovery (lower LVEF) compared to the C allele in women with peripartum cardiomyopathy?
The GNB3 TT genotype, which is more prevalent in black women, is associated with poorer myocardial recovery in peripartum cardiomyopathy.
May inform prognosis in peripartum cardiomyopathy; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: Black women are at greater risk for peripartum cardiomyopathy (PPCM). The guanine nucleotide-binding proteins β-3 subunit (GNB3) has a polymorphism C825T. The GNB3 TT genotype more prevalent in blacks is associated with poorer outcomes. We evaluated GNB3 genotype and myocardial recovery in PPCM. METHODS AND RESULTS: A total of 97 women with PPCM were enrolled and genotyped for the GNB3 T/C polymorphism. Left ventricular ejection fraction (LVEF) was assessed by echocardiography at entry, 6 and 12 months postpartum. LVEF over time in subjects with the GNB3 TT genotype was compared with those with the C allele overall and in black and white subsets. The cohort was 30% black, age 30+6, LVEF 0.34+0.10 at entry 31+25 days postpartum. The % GNB3 genotype for TT/CT/CC=23/41/36 and differed markedly by race (blacks=52/38/10 versus whites=10/44/46, P<0.001). In subjects with the TT genotype, LVEF at entry was lower (TT=0.31+0.09; CT+CC=0.35+0.09, P=0.054) and this difference increased at 6 (TT=0.45+0.15; CT+CC=0.53+0.08, P=0.002) and 12 months (TT=0.45+0.15; CT+CC=0.56+0.07, P<0.001.). The difference in LVEF at 12 months by genotype was most pronounced in blacks (12 months LVEF for GNB3 TT=0.39+0.16; versus CT+CC=0.53+0.09, P=0.02) but evident in whites (TT=0.50++0.11; CT+CC=0.56+0.06, P=0.04). CONCLUSIONS: The GNB3 TT genotype was associated with lower LVEF at 6 and 12 months in women with PPCM, and this was particularly evident in blacks. Racial differences in the prevalence and impact of GNB3 TT may contribute to poorer outcomes in black women with PPCM.
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Sheppard et al. (2016) conducted a cohort in Peripartum cardiomyopathy (n=97). GNB3 TT genotype vs. GNB3 CT or CC genotype (C allele) was evaluated on Left ventricular ejection fraction (LVEF) at 12 months (p=<0.001). In women with peripartum cardiomyopathy, the GNB3 TT genotype was associated with lower left ventricular ejection fraction at 12 months compared to the C allele (0.45 vs 0.56, P<0.001).
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