Association of the angiotensinogen M235T polymorphism with recurrence after catheter ablation of acquired atrial fibrillation
Association of the angiotensinogen M235T polymorphism with recurrence after catheter ablation of acquired atrial fibrillation
复制标题
DOI：
10.1177/1470320315594315
复制
发表时间：
2015-12-01
影响因子：
2.9
通讯作者：
Li, Yi-Gang
中科院分区：
文献类型：
--
作者：
Wang, Qunshan;Hu, Xiaofeng;Li, Yi-Gang
目的：先前的研究表明，血管紧张素原（AGT）基因的遗传变异会增加获得性心房颤动（AF）的风险。本研究调查了导管消融（CA）后获得性房颤患者的AGT变异是否与临床结果相关。方法：回顾性分析150例获得性症状性药物难治性房颤患者（平均年龄63.711.0岁，非阵发性房颤占24.6%）在我科行单次房颤CA手术。对8个AGT基因标记单核苷酸多态性（tSNPs）进行了基因分型。在平均57.5个月的随访期间进行标准心电图（ECGs）和24小时动态心电图记录以检测AF复发。结果：随访期间，61例（40.7%）患者在单次CA手术后房颤复发。在8个tsps中，M235T的M等位基因频率在复发组（28%）显著高于非复发组（18%）（p=0.042）。TT、MT、MM基因型患者复发率分别为34.4%、50%、55.6% （p(trend)=0.049）。在校正年龄、性别、体重指数、高血压、左房容积指数（LAVI）等协变量后，M235T在加性模型和优势模型中分别增加AF复发风险，比值比分别为2.023（95%置信区间（CI）： 1.034 ~ 3.926, p=0.033）和2.601 （95% CI: 1.102 ~ 6.056, p=0.025）。但在多重校正分析中，多重比较的p值均无统计学意义（p（正）0.05）。结论：M235T的M等位基因可能与CA后房颤复发风险增加有关，因此基因分型可能有助于识别CA后房颤复发风险较高的患者并制定最佳随访策略。这些策略可能不同，应根据患者的基因型进行个体化。未来的研究需要验证AGT M235T对CA后AF复发的潜在影响。
Purpose: Previous studies showed that genetic variants of the angiotensinogen (AGT) gene conferred higher risk for acquired atrial fibrillation (AF). The present study investigated whether AGT variants correlate with the clinical outcome in patients with acquired AF after catheter ablation (CA).Methods: A total of 150 acquired symptomatic drug-refractory AF patients (mean age 63.711.0 years, 24.6% non-paroxysmal AF) with acquired AF underwent a single CA procedure in our department and were included in this retrospective analysis. Eight tagging single nucleotide polymorphisms (tSNPs) in the AGT gene were genotyped. Standard electrocardiographs (ECGs) and 24-hour Holter recordings were performed during a median follow-up period of 57.5 months to detect AF recurrence.Results: Sixty-one patients (40.7%) suffered AF recurrences after a single CA procedure during follow up. Of the eight tSNPs, the frequency of the M allele of M235T was significantly higher in the recurrence group (28%) compared to the non-recurrence group (18%) (p=0.042). The recurrence rates of patients with the TT, MT, and MM genotypes were 34.4%, 50%, and 55.6%, respectively (p(trend)=0.049). After adjusting for age, sex, body mass index, hypertension, left atrial volume index (LAVI) and other covariates, M235T increased the risk of AF recurrence in additive and dominant models with odds ratios of 2.023 (95% confidence interval (CI): 1.034-3.926, p=0.033) and 2.601 (95% CI: 1.102-6.056, p=0.025), respectively. However, in multiple correction analyses, the p values of multiple comparisons were not statistically significant (p(correct)>0.05).Conclusions: The M allele of M235T might be associated with an increased risk of AF recurrence after CA. Genotyping may thus be helpful on identifying patients with higher risks of AF recurrence after CA and developing optimal follow-up strategies. These strategies may differ and should be individualized according to patients' genotype. Future studies are warranted to validate the potential effect of AGT M235T on AF recurrence post CA.