Key result
Beta-2 Glu27Glu carriers demonstrated greater left ventricular reverse remodelling after cardiac resynchronization therapy compared to Gln27Gln carriers (LVEF change 11 vs 3.1 units; P=0.018).
Why the study?
Do beta-adrenergic receptor gene polymorphisms influence left ventricular reverse remodelling and appropriate ICD shocks in heart failure patients undergoing CRT?
Cohort (n=101)
Do beta-adrenergic receptor gene polymorphisms influence left ventricular reverse remodelling and appropriate ICD shocks in heart failure patients undergoing CRT?
Absolute Event Rate: 11% vs 3.1%
p-value: p=0.018
Beta-2 Gln27Glu adrenergic receptor gene polymorphism may predict the extent of left ventricular reverse remodelling and risk of malignant ventricular tachyarrhythmias after cardiac resynchronization therapy.
May inform genotype-based CRT response stratification; leaves open need for prospective validation before clinical use.
AIMS: Several factors can influence the extent of left ventricular (LV) reverse remodelling after cardiac resynchronization therapy (CRT) in patients with heart failure (HF). Polymorphism in genes involved in cardiac remodelling, namely beta-adrenergic receptors (ARs), may have a role. We studied the influence of beta-1 Arg389Gly, beta-2 Arg16Gly, and beta-2 Gln27Glu ARs gene polymorphisms on the magnitude of reverse remodelling response to CRT and its possible correlations with the incidence of appropriate implantable cardioverter-defibrillator (ICD) shocks. METHODS AND RESULTS: Beta-ARs were assessed in 101 patients with HF due to idiopathic (50.5%) or ischaemic (49.5%) dilated cardiomyopathy, undergoing CRT for standard indications [left ventricular ejection fraction (LVEF) 23.5 ± 7.5%, QRS ≥ 120 ms]. Left ventricular ejection fraction was measured by echocardiography at baseline, 6 months after CRT, and periodically afterwards. The LVEF change from baseline was of 3.1 ± 11 units among Gln27Gln, 8.3 ± 10.4 units among Gln27Glu, 11 ± 6.4 units among Glu27Glu carriers (P = 0.018 for Gln27Gln vs. Glu27Glu carriers), and 8.8 ± 9.8 units among Gln27Glu + Glu27Glu carriers (P = 0.006 vs. Gln27Gln). Gln27 homozygotes had a higher incidence of appropriate ICD shocks for fast ventricular tachycardia/ventricular fibrillation. CONCLUSION: Beta-2 Gln27Glu ARs gene polymorphism may influence LV reverse remodelling after CRT with Glu27Glu carriers showing the greatest improvement. It may also influence the incidence of malignant ventricular tachyarrhythmias.
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Pezzali et al. (2013) conducted a cohort in Heart failure (n=101). Beta-2 Gln27Glu ARs gene polymorphism (Glu27Glu carriers) vs. Gln27Gln carriers was evaluated on Left ventricular ejection fraction (LVEF) change from baseline (p=0.018). Beta-2 Glu27Glu carriers demonstrated greater left ventricular reverse remodelling after cardiac resynchronization therapy compared to Gln27Gln carriers (LVEF change 11 vs 3.1 units; P=0.018).
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