Kaczmarczyk M, Biernawska J, Zukowski M, Kotfis K, Zegan-Barańska M, Bińczak-Kuleta A, Ciechanowicz A, Brykczyński M, Bohatyrewicz R
Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, Szczecin, Poland.
Transplant Proc. 2011 Oct;43(8):2964-6. doi: 10.1016/j.transproceed.2011.08.035.
The mechanisms of sudden cardiac death are difficult to recognize, but repolarization disturbances have been shown to be the cause. The purpose of this study was to investigate whether the polymorphism of nitric oxide synthase 1 adaptor protein (NOS1AP) was related to the risk of occurrence of corrected QTc-interval prolongation and ventricular arrhythmias recorded on electrocardiography (ECG) Holter monitoring in kidney transplant recipients.
The 75 adult first kidney transplant patients included 43 men with an overall mean age of 45±12 years (range, 20-68). Additional patient monitoring during the procedure and in the postoperative period consisted of a continuous ECG tracing recording and investigation of the rs10918594 NOS1AP polymorphism.
We observed Transient QTc-interval prolongation during the perioperative period. NOS1AP genotypes were in Hardy-Weinberg equilibrium. For further statistical analysis, we combined GG homozygotes and CG heterozygotes because of the small numbers available; therefore, only a dominant mode of inheritance was investigated. There were no gender differences in QTc-interval patterns. Analysis of variance with repeated measures revealed no interaction between NOS1AP and QTc-interval values taken at various times among the kidney recipients.
The transplantation procedure may lead to dynamic repolarization disturbances, which may produce an increased risk of severe arrhythmias despite optimization of patient status. The NOS1AP rs203462 polymorphisms did not correlate with an increased risk of QT interval prolongation among kidney recipients.
心源性猝死的机制难以识别，但已证实复极紊乱是其病因。本研究旨在探讨一氧化氮合酶1衔接蛋白（NOS1AP）基因多态性是否与肾移植受者心电图（ECG）动态心电图监测记录的校正QT间期延长和室性心律失常的发生风险相关。
75例成年首次肾移植患者包括43例男性，总体平均年龄为45±12岁（范围20 - 68岁）。手术过程中和术后对患者的额外监测包括连续心电图记录以及对rs10918594 NOS1AP基因多态性的检测。
我们观察到围手术期出现短暂的QT间期延长。NOS1AP基因型符合哈迪 - 温伯格平衡。由于可用样本数量较少，为进行进一步的统计分析，我们将GG纯合子和CG杂合子合并；因此，仅研究显性遗传模式。QT间期模式不存在性别差异。重复测量方差分析显示，肾移植受者中NOS1AP与不同时间点的QT间期值之间无相互作用。
移植手术可能导致动态复极紊乱，尽管患者状况已得到优化，但仍可能增加严重心律失常的风险。NOS1AP rs203462基因多态性与肾移植受者QT间期延长风险增加无关。
