Genetic background of ventricular tachyarrhythmias associated with acute myocardial ischemia

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We tried to elucidate the genetic background of ventricular tachyarrhythmias (VTAs) associated with acute coronary ischemia in Japanese patients. We analyzed KCNQ1, KCNH2, KCNE1, KCNE2 and SCN5A in four patients with post myocardial infarction/ischemia-associated torsades de pointes (ACS-TdP), and identified KCNQ1 G643S variant in two patients. The allele frequency of this variant is more common in Asian (about 6 %) than other ethnic groups (white: 0 %). However, it was reported to be associated with secondary long QT syndrome. In contrast, KCNH2 K897T variant, which is prevalent in Caucasian, was reported to be identified in 9 out of 13 Caucasian ACS-TdP patients. Moreover, we analyzed above genes in 8 patients who experienced VTAs associated with vasospastic angina, and identified SCN5A R1193Q, SCN5A L1988R/SCN5A H558R, KCNH2 P10S/SCN5A H558R in three patients. Our data suggest that there may be an ethnic-specific genetic background in VTAs associated with acute coronary ischemia.