Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
J Card Fail. 2010 Jan;16(1):36-44. doi: 10.1016/j.cardfail.2009.08.003. Epub 2009 Sep 25.
This study evaluated the potential effects of beta-adrenoceptor (beta-AR) and natriuretic peptide receptor (NPR) gene polymorphisms on the susceptibility to and the severity of idiopathic dilated cardiomyopathy (IDCM) in a Chinese cohort.
Ten polymorphisms in the coding regions of beta1-AR, beta2-AR, beta3-AR, NPR1, and NPR2 were genotyped in 430 IDCM patients and 468 healthy subjects. Patients with IDCM were followed for 2 years. In multi-loci combined subtype analysis, the combined profile of beta-AR and NPR was significantly different between IDCM patients and controls (P < .0001), mainly influenced by 2 loci beta1-Ser49Gly and NPR2-C2077T, which were also associated with the severity of IDCM. In single-loci analysis, allele frequencies of beta1-Gly49, NPR1-Glu939, and NPR2-T2077 were higher in patients with IDCM than in controls. Genotypes carrying NPR2-T2077 allele showed 1.94-fold independent risk for IDCM phenotype than C2077 homozygote (P < .001). Carriers of the NPR2-T2077 or beta1-Gly49 variant had worse New York Heart Association functional class or echocardiographic results and elevated serum brain natriuretic peptide, experienced severe symptoms, and required intensive medications and frequent hospitalization for heart failure. Furthermore, synergistic interactions between NPR2-C2077T and beta1-Ser49Gly were detected by multifactor-dimensionality reduction method.
This study suggests that NPR2-T2077 and beta1-Gly49 polymorphisms may be genetically synergistic adverse factors for the susceptibility to or the severity of IDCM.
本研究评估了β-肾上腺素能受体(β-AR)和利钠肽受体(NPR)基因多态性对特发性扩张型心肌病(IDCM)易感性和严重程度的潜在影响。
对 430 例 IDCM 患者和 468 例健康对照者的编码区 10 个β1-AR、β2-AR、β3-AR、NPR1 和 NPR2 多态性进行了基因分型。对 IDCM 患者进行了 2 年的随访。在多基因联合亚类分析中,IDCM 患者和对照组之间β-AR 和 NPR 的联合表型明显不同(P<0.0001),主要受β1-Ser49Gly 和 NPR2-C2077T 2 个位点的影响,这两个位点也与 IDCM 的严重程度有关。在单基因座分析中,IDCM 患者β1-Gly49、NPR1-Glu939 和 NPR2-T2077 等位基因频率高于对照组。携带 NPR2-T2077 等位基因的基因型发生 IDCM 表型的独立风险是 C2077 纯合子的 1.94 倍(P<0.001)。携带 NPR2-T2077 或β1-Gly49 变异的个体心功能纽约分级(NYHA)较差或超声心动图结果较差,血清脑利钠肽水平升高,症状严重,需要强化药物治疗和频繁住院心衰。此外,多因子降维法检测到 NPR2-C2077T 和β1-Ser49Gly 之间存在协同相互作用。
本研究提示 NPR2-T2077 和β1-Gly49 多态性可能是 IDCM 易感性或严重程度的遗传协同不利因素。