Jeff Janina M, Brown-Gentry Kristin, Buxbaum Sarah G, Sarpong Daniel F, Taylor Herman A, George Alfred L, Roden Dan M, Crawford Dana C
Center for Human Genetics Research, Vanderbilt University, Nashville, TN 37232-0700, USA.
Circ Cardiovasc Genet. 2011 Apr;4(2):139-44. doi: 10.1161/CIRCGENETICS.110.958124. Epub 2011 Feb 15.
Understanding variation in the normal electric activity of the heart, assessed by the ECG, may provide a starting point for studies of susceptibility to serious arrhythmias such as sudden cardiac death during myocardial infarction or drug therapy. Recent genetic association studies of one ECG trait, the QT interval, have identified common variation in European-descent populations, but little is known about the genetic determinants of ECG traits in populations of African descent.
To identify genetic risk factors, we have undertaken a candidate gene study of ECG traits in collaboration with the Jackson Heart Study, a longitudinal study of 5301 blacks ascertained from the Jackson, Mississippi, area. Nine quantitative ECG traits were evaluated: P, PR, QRS, QT, and QTc durations, heart rate, and P, QRS, and T axes. We genotyped 72 variations in the predominant sodium channel gene expressed in heart, SCN5A, encoding the Na(v)1.5 voltage-gated sodium channel in 4558 subjects. Both rare and common variants in this gene have previously been associated with inherited arrhythmia syndromes and variable conduction. Adjusting for age, sex, and European ancestry, we performed tests of association in 3054 unrelated participants and identified 14 significant associations (P<1.0×10(-4)), of which 13 are independent, based on linkage disequilibrium. These variants explain up to 2% of the variation in ECG traits in the Jackson Heart Study.
These results suggest that SCN5A variation contributes to ECG trait distributions in blacks, and these same variations may be risk or protective factors associated with susceptibility to arrhythmias.
通过心电图评估了解心脏正常电活动的变化,可能为研究心肌梗死或药物治疗期间严重心律失常(如心源性猝死)的易感性提供一个起点。最近对一项心电图特征——QT间期的基因关联研究,已在欧洲裔人群中确定了常见变异,但对于非洲裔人群中心电图特征的遗传决定因素知之甚少。
为了确定遗传风险因素,我们与杰克逊心脏研究合作开展了一项关于心电图特征的候选基因研究,该研究是对从密西西比州杰克逊地区确定的5301名黑人进行的纵向研究。评估了九项定量心电图特征:P波、PR间期、QRS波群、QT间期和QTc间期时长、心率以及P波、QRS波群和T波电轴。我们对4558名受试者中在心脏中表达的主要钠通道基因SCN5A的72个变异进行了基因分型,该基因编码Na(v)1.5电压门控钠通道。此前,该基因中的罕见和常见变异均与遗传性心律失常综合征及可变传导有关。在对年龄、性别和欧洲血统进行校正后,我们在3054名无亲缘关系的参与者中进行了关联测试,并确定了14个显著关联(P<1.0×10⁻⁴),其中基于连锁不平衡,有13个是独立的。这些变异在杰克逊心脏研究中解释了高达2%的心电图特征变异。
这些结果表明,SCN5A变异促成了黑人心电图特征的分布,并且这些相同的变异可能是与心律失常易感性相关的风险或保护因素。