Wu Zhijun, Xu Min, Sheng Haihui, Lou Yuqing, Su Xiuxiu, Chen Yanjia, Lu Lin, Liu Yan, Jin Wei
Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
National Engineering Center for Biochip at Shanghai Shanghai, China.
Int J Clin Exp Pathol. 2014 Sep 15;7(10):7148-57. eCollection 2014.
Left ventricular dysfunction (LVD) occurs with myocardial ischemia and coronary artery disease (CAD). The natriuretic peptide system has compensatory vasodilatory, natriuretic and paracrine effects on LVD and subsequent heart failure. The aim of this study was to investigate the relationship between natriuretic peptide polymorphisms and risk of LVD in CAD patients.
We recruited 747 consecutive Southern Han Chinese patients with angiographically confirmed CAD, 201 had a reduced left ventricle ejection fraction (LVEF ≤45%, LVD group) and 546 had a preserved left ventricle ejection fraction (LVEF >45%). The reduced and preserved LVEF groups were matched by gender and age. Taqman assays were performed to identify five polymorphisms in the NPPA-NPPB locus (rs5065, rs5063, rs632793, rs198388 and rs198389).
Single-locus analyses found no significant difference in the allele and genotype frequencies of the reduced and preserved LVEF group, even after adjusting for confounding factors. Subgroup analyses performed by hyperlipidemia (HLP) demonstrated 3 polymorphisms, rs632793 (OR = 0.31, 95% CI 0.1-0.93, P = 0.04), rs198388 (OR = 0.26, 95% CI 0.09-0.79, P = 0.02) and rs198389 (OR = 0.26, 95% CI 0.09-0.80, P = 0.02) were associated with the reduced risk of LVD. No CAD-susceptible haplotypes were identified. Multifactor dimensionality reduction analysis did not detect any gene-to-gene interactions among the five loci. Three loci (rs5063, rs632793 and rs198388) formed the best model with the maximum testing accuracy (39.89%) and cross-validation consistency (10/10).
Three NPPA-NPPB polymorphisms (rs632793, rs198388 and rs198389) were associated with reduced risk of LVD in CAD patients with HLP.
左心室功能障碍(LVD)与心肌缺血和冠状动脉疾病(CAD)相关。利钠肽系统对LVD及随后的心力衰竭具有代偿性血管舒张、利钠和旁分泌作用。本研究旨在探讨利钠肽基因多态性与CAD患者发生LVD风险之间的关系。
我们连续招募了747例经血管造影证实患有CAD的中国南方汉族患者,其中201例左心室射血分数降低(LVEF≤45%,LVD组),546例左心室射血分数正常(LVEF>45%)。左心室射血分数降低组和正常组按性别和年龄进行匹配。采用Taqman分析方法鉴定NPPA-NPPB基因座中的5个多态性位点(rs5065、rs5063、rs632793、rs198388和rs198389)。
单基因座分析发现,即使在调整混杂因素后,左心室射血分数降低组和正常组的等位基因和基因型频率仍无显著差异。高脂血症(HLP)亚组分析显示,3个多态性位点rs632793(OR=0.31,95%CI 0.1-0.93,P=0.04)、rs198388(OR=0.26,95%CI 0.09-0.79,P=0.02)和rs198389(OR=0.26,95%CI 0.09-0.80,P=0.02)与LVD风险降低相关。未发现CAD易感单倍型。多因素降维分析未检测到5个基因座之间存在任何基因-基因相互作用。3个基因座(rs5063、rs632793和rs198388)构成了最佳模型,其测试准确性最高(39.89%),交叉验证一致性为10/10。
3个NPPA-NPPB基因多态性位点(rs632793、rs198388和rs198389)与HLP型CAD患者发生LVD的风险降低相关。