Plante Isabelle, Fournier Dominique, Mathieu Patrick, Daleau Pascal
Quebec Heart Institute, Quebec, Quebec.
Can J Cardiol. 2008 Jan;24(1):41-4. doi: 10.1016/s0828-282x(08)70546-4.
Postoperative atrial fibrillation (AF) is a frequent complication following cardiac surgery. Risk factors leading to the development of postoperative AF are not well known and may be influenced by mutations of specific channels involved in atrial repolarization. Recently, the authors have identified three single nucleotide polymorphisms (SNPs) (R87Q, A251T and P307S) in the voltage-gated potassium channel hKv1.5 in a French-Canadian population. Two of these, R87Q and P307S, modified the gating process and the expression level of the hKv1.5 channel.
Considering that these SNPs may accelerate atrial repolarization, it was hypothesized that they may predispose patients to postoperative AF.
The authors tested the presence of SNPs in the hKv1.5 channel among 185 patients undergoing coronary artery bypass graft surgery.
In the postoperative period, 96 patients (52%) developed a new onset of AF. A higher prevalence of SNPs was found among patients who developed postoperative AF than in the population without this postoperative arrhythmia (6.25% versus 3.37%; P=0.42). Respective allelic frequencies for R87Q and P307S were 0.52% and 1.56% in the postoperative AF group versus 0% and 0.56% in the non-AF group. Families of the carrier patients were also screened, and several members were found who carried the SNPs but did not have AF. The A251T SNP is not likely to be responsible for AF because it does not modify hKv1.5 channel functions.
A genetic background that may be involved in the occurrence of postoperative AF was identified. Therefore, R87Q and P307S polymorphisms in hKv1.5, possibly in combination with other risk factors, may influence the development of postoperative AF.
术后房颤是心脏手术后常见的并发症。导致术后房颤发生的危险因素尚不明确,可能受参与心房复极的特定通道突变影响。最近,作者在法裔加拿大人群中鉴定出电压门控钾通道hKv1.5中的三个单核苷酸多态性(SNP)(R87Q、A251T和P307S)。其中两个,R87Q和P307S,改变了hKv1.5通道的门控过程和表达水平。
鉴于这些SNP可能加速心房复极,推测它们可能使患者易患术后房颤。
作者检测了185例接受冠状动脉搭桥手术患者的hKv1.5通道中SNP的存在情况。
术后,96例患者(52%)出现新发房颤。发生术后房颤的患者中SNP的患病率高于无这种术后心律失常的人群(6.25%对3.37%;P = 0.42)。术后房颤组中R87Q和P307S的等位基因频率分别为0.52%和1.56%,而非房颤组为0%和0.56%。还对携带SNP患者的家族进行了筛查,发现有几个成员携带SNP但未患房颤。A251T SNP不太可能导致房颤,因为它不改变hKv1.5通道功能。
确定了一个可能与术后房颤发生有关的遗传背景。因此,hKv1.5中的R87Q和P307S多态性,可能与其他危险因素共同作用,可能影响术后房颤的发生。