Lone and secondary nonvalvular atrial fibrillation: Role of a genetic susceptibility
Lone and secondary nonvalvular atrial fibrillation: Role of a genetic susceptibility
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DOI：
10.1016/j.ijcard.2006.08.079
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发表时间：
2007-08-01
影响因子：
3.5
通讯作者：
Gensini, Gian Franco
中科院分区：
文献类型：
--
作者：
Fatini, Cinzia;Sticchi, Elena;Gensini, Gian Franco
背景：肾素-血管紧张素系统参与房颤的发病机制已被认为是房颤的发病机制之一，而血管紧张素转换酶基因DD可能影响房颤的易感性。本研究旨在探讨血管紧张素转换酶基因I/D多态性与房颤、孤立性和继发性非瓣膜性房颤(NVAF)的关系。方法：对510例确诊为房颤的患者(其中孤立性房颤106例，继发性非瓣膜性房颤404例)和520例无心血管病史的对照组进行研究。结果：孤立性和继发性非瓣膜性房颤的等位基因频率存在显著差异(P=0.002)。在单因素和多因素分析中，在调整年龄和性别后，在显性、隐性和加性模型下，ACE D等位基因与孤立性NVAF的易感性有关(多因素分析：显性OR=2.87p=0.02；隐性OR=2.01p=0.003；加性OR=4.47p<；0.0001)。在隐性和加性模型下，ACE D等位基因与继发性NVAF的单因素和多因素分析均显著相关(多变量分析：隐性OR=1.89，p=0.001；加性OR=2.5，p&t；0.0001)。结论：本研究强调了ACE基因在孤立性和继发性NVAF的易感性中的作用，进一步有助于揭示这种复杂疾病的遗传机制。我们结果的临床相关性可能与在没有传统危险因素的情况下易发生NVAF的受试者的可能特征有关，也可能与使用能够改善致心律失常底物的ACE抑制剂治疗有关。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
Background: An involvement of the renin angiotensin system in atrial fibrillation (AF) has been hypothesized, and ACE DD genotype has been suggested to influence the predisposition to AF. The aim of this study was to investigate the role of the ACE I/D polymorphism in relation to the different clinical forms of AF, lone and secondary nonvalvular atrial fibrillation (NVAF).Methods: 510 consecutive patients with documented NVAF (106 patients had lone, and 404 secondary NVAF), and 520 controls with a negative history of cardiovascular disease have been studied.Results: A significant difference in allele frequency between lone and secondary NVAF (p= 0.002) has been found. The ACE D allele was associated with the predisposition to lone NVAF under a dominant, recessive and additive model, both at univariate and multivariate analysis, after adjustment for age and gender (multivariate analysis: dominant OR= 2.87, p= 0.02; recessive OR= 2.01, p= 0.003; additive OR= 4.47, p < 0.0001). ACE D allele was significantly associated with secondary NVAF at both univariate and multivariate analysis under a recessive and additive, but not dominant, model (multivariate analysis: recessive OR= 1.89, p= 0.001; additive OR= 2.50, p < 0.0001).Conclusions: This study highlights the role of ACE gene in predisposing to both lone and secondary NVAF, further contributing to penetrate the genetic mechanisms responsible for this complex disease. The clinical relevance of our results may be related to the possible characterization of subjects predisposed to NVAF in the absence of traditional risk factors, and to the use of ACE-inhibitors therapy able to improve the arrhythmogenic substrate. (C) 2006 Elsevier Ireland Ltd. All rights reserved.