Aldosterone synthase gene polymorphism as a determinant of atrial fibrillation in patients with heart failure
Aldosterone synthase gene polymorphism as a determinant of atrial fibrillation in patients with heart failure
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DOI：
10.1016/j.amjcard.2008.03.063
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发表时间：
2008-08-01
影响因子：
2.8
通讯作者：
Lewis, Basil S.
中科院分区：
文献类型：
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作者：
Amir, Offer;Amir, Ruthie E.;Lewis, Basil S.
我们分析了醛固酮合成酶（CYP11B2） T-344C多态性（与醛固酮活性增加有关）与房颤（AF）患病率之间的可能关联，196例连续患者在招募前3个月出现症状性收缩期心力衰竭（HF）；左心室射血分数=心房颤动（AF）。使用标准方案从外周血白细胞中提取基因组DNA。采用聚合酶链反应/限制性片段长度多态性方法对受试者进行CYP11B2多态性基因分型。心衰患者中有63例（33%）存在房颤。我们发现-344 CC基因型是房颤的一个强大的独立标记。该基因型患者中有近1/2（45%）患有房颤，而-344 TT和TC基因型患者中有1/4（27%）患有房颤（p = 0.01）。纳入年龄、性别、纽约心脏协会分类、CYP11B2 -344CC基因型、左室射血分数、左房尺寸、左室舒张末期内径和二尖瓣反流严重程度的多变量逐步logistic回归模型显示，CYP11B2 -344CC基因型（经年龄和左房尺寸校正）是房颤的独立预测因子（校正优势比2.35,95%置信区间1.57 ~ 3.51,p = 0.03）。综上所述，CYP11B2 T-344C启动子多态性易导致心衰患者发生临床房颤。(C) 2008爱思唯尔公司版权所有。
We analyzed the possible association between aldosterone synthase (CYP11B2) T-344C polymorphism, which is associated with increased aldosterone activity, and the prevalence of atrial fibrillation (AF) in 196 consecutive patients who had symptomatic systolic heart failure (HF; left ventricular ejection fraction = 3 months before recruitment. Genomic DNA was extracted from peripheral blood leukocytes using a standard protocol. Subjects were genotyped for the CYP11B2 polymorphism using the polymerase chain reaction/restriction fragment length polymorphism approach. AF was present in 63 patients (33%) with HF. We found the -344 CC genotype to be a strong independent marker for AF. Almost 1/2 (45%) of patients with this genotype had AF compared with 1/4 (27%) with -344 TT and TC genotypes (p = 0.01). A multivariate stepwise logistic regression model that included age, gender, New York Heart Association class, CYP11B2 -344CC genotype, and echocardiographic measurements of left ventricular ejection fraction, left atrial dimension, left ventricular end-diastolic diameter, and mitral regurgitation severity showed that the CYP11B2 CC genotype (adjusted for age and left atrial size) was an independent predictor of AF (adjusted odds ratio 2.35, 95% confidence interval 1.57 to 3.51, p = 0.03). In conclusion, CYP11B2 T-344C promoter polymorphism predisposes to clinical AF in patients with HF. (C) 2008 Elsevier Inc. All rights reserved.