Key result
Arg389Arg genotype linked to ~56% fewer syncopal episodes than Arg389Gly on beta-blocker therapy.
Why the study?
The role of beta-blockers in the treatment of vasovagal syncope is controversial, and the effect of beta-1 receptor gene polymorphism on beta-blocker therapy response in VVS patients was unclear.
Cohort (n=123)
Double-blind
No
Absolute Event Rate: 3% vs 6.8%
p-value: p=<0.001
Should not yet guide genotype-based beta-blocker use in syncope; leaves open a potential association requiring prospective validation.
BACKGROUND: Vasovagal syncope (VVS) is a common clinical condition involving genetic background. The role of beta-blockers in the treatment is controversial. OBJECTIVE: The aim of this study was to investigate the effect of beta-1 gene polymorphism on beta-blocker therapy in patients with VVS. METHODS: We included 123 patients who were diagnosed with VVS after the tilttable test. We searched for the polymorphism Arg389Gly (rs1801253) in the beta-1 adrenoceptor gene. RESULTS: Overall, 64 patients (52%) had Arg389Arg with Arg389Arg genotype were more frequent compared with patients having Arg389Gly genotype (total syncopal episodes [TSE], 7.9 ± 3.7 vs. 6.4 ± 3.0; p = 0.012). TSE in patients with Arg389Arg genotype decreased significantly after 18 months of beta-blocker treatment (7.9 ± 3.7 vs. 3.0 ± 1.4, p < 0.001). After 18 months of beta-blocker treatment, patients with Arg389Arg genotype had significantly fewer syncopal episodes than patients with Arg389Gly genotype (3.0 ± 1.4 vs. 6.8 ± 3.2, p < 0.001). CONCLUSIONS: Results of beta-blocker therapy in patients with Arg389Arg genotype suggest that VVS pathophysiology is a multifactorial condition, with genetic, psychological, and environmental components, and therefore, treatment selection can be based on gene polymorphism.
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Atıcı et al. (2020) conducted a cohort in Vasovagal syncope (VVS) (n=123). ADRB1 Arg389Arg genotype vs. Arg389Gly genotype was evaluated on Total syncopal episodes at 18 months (p=<0.001). After 18 months of beta-blocker treatment, patients with the Arg389Arg genotype experienced significantly fewer syncopal episodes than patients with the Arg389Gly genotype (3.0 vs. 6.8 episodes, p < 0.001).
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