Key result
Patients with acute coronary syndrome homozygous for the Gln27Gln polymorphism exhibited exaggerated muscle sympathetic nerve activity and mean blood pressure responses during exercise compared to those carrying the Glu allele.
Why the study?
Does exercise training improve neurovascular control during exercise in ACS patients depending on their ADRB2 Gln27Glu polymorphism?
Observational (n=61)
No
Does exercise training improve neurovascular control during exercise in ACS patients depending on their ADRB2 Gln27Glu polymorphism?
Absolute Event Rate: 11% vs 4%
p-value: p=0.02
Exercise training restores exaggerated sympathetic and blood pressure responses in ACS patients homozygous for the ADRB2 Gln27 allele, highlighting a genotype-specific physiological benefit of cardiac rehabilitation.
Gln27Gln may signal higher sympathetic reactivity during exercise in ACS; leaves open genotype-specific risk stratification or training responses for prospective study.
BACKGROUND: Gln27Glu (rs1042714) polymorphism of the β2-adrenergic receptor (ADRB2) has been association with cardiovascular functionality in healthy subjects. However, it is unknown whether the presence of the ADRB2 Gln27Glu polymorphism influences neurovascular responses during exercise in patients with acute coronary syndromes (ACS). We tested the hypothesis that patients with ACS homozygous for the Gln allele would have increased muscle sympathetic nerve activity (MSNA) responses and decreased forearm vascular conductance (FVC) responses during exercise compared with patients carrying the Glu allele (Gln27Glu and Glu27Glu). In addition, exercise training would restore these responses in Gln27Gln patients. METHODS AND RESULTS: Thirty-days after an ischemic event, 61 patients with ACS without ventricular dysfunction were divided into 2 groups: (1) Gln27Gln (n = 35, 53±1years) and (2) Gln27Glu+Glu27Glu (n = 26, 52±2years). MSNA was directly measured using the microneurography technique, blood pressure (BP) was measured with an automatic oscillometric device, and blood flow was measured using venous occlusion plethysmography. MSNA, mean BP, and FVC were evaluated at rest and during a 3-min handgrip exercise. The MSNA (P = 0.02) and mean BP (P = 0.04) responses during exercise were higher in the Gln27Gln patients compared with that in the Gln27Glu+Glu27Glu patients. No differences were found in FVC. Two months of exercise training significantly decreased the MSNA levels at baseline (P = 0.001) and in their response during exercise (P = 0.02) in Gln27Gln patients, but caused no changes in Gln27Glu+Glu27Glu patients. Exercise training increased FVC responses in Gln27Glu+Glu27Glu patients (P = 0.03), but not in Gln27Gln patients. CONCLUSION: The exaggerated MSNA and mean BP responses during exercise suggest an increased cardiovascular risk in patients with ACS and Gln27Gln polymorphism. Exercise training emerges as an important strategy for restoring this reflex control. Gln27Glu polymorphism of ADRB2 influences exercise-induced vascular adaptation in patients with ACS.
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Ferreira‐Santos et al. (2017) conducted an observational in Acute coronary syndrome (n=61). Gln27Gln polymorphism of ADRB2 vs. Gln27Glu + Glu27Glu polymorphisms was evaluated on Muscle sympathetic nerve activity (MSNA) response (delta bursts/100HB) during exercise (p=0.02). Patients with acute coronary syndrome homozygous for the Gln27Gln polymorphism exhibited exaggerated muscle sympathetic nerve activity and mean blood pressure responses during exercise compared to those carrying the Glu allele.
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