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A激酶锚定蛋白10功能基因变异对高危血管手术患者获得性复极障碍的易感性。

Predisposition of functional genetic variants of A-kinase anchoring protein 10 toward acquired repolarization disorders in high-risk vascular surgery patients.

作者信息

Biernawska Jowita, Solek-Pastuszka Joanna, Kazimierczak Arkadiusz, Safranow Krzysztof, Kaczmarczyk Mariusz, Zegan-Baranska Malgorzata, Zukowski Maciej, Kotfis Katarzyna

机构信息

Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University, Szczecin, Poland,

Department of Angiology and Vascular Surgery, Pomeranian Medical University, Szczecin, Poland.

出版信息

Ther Clin Risk Manag. 2018 Jul 26;14:1315-1322. doi: 10.2147/TCRM.S167086. eCollection 2018.

Abstract

PURPOSE

We aimed at assessing the predisposition of A-kinase anchoring protein 10 (AKAP10) polymorphism toward acquired repolarization disorders in high-risk vascular surgery patients.

PATIENTS AND METHODS

One hundred adult patients (age =44-85 years), scheduled for an elective high-risk "open" vascular surgery procedure, were recruited. The electrocardiogram Holter monitor was used to assess repolarization stability from the beginning of the operation up to 24 hours afterward. The AKAP10 gene rs203462 polymorphism and cardiac complications were analyzed.

RESULTS

Repolarization disturbances defined as QT interval duration corrected for heart rate (QTc) interval prolongation >500 ms and QTc interval dispersion >65 ms were recorded in 46 patients. A model of multivariate logistic regression showed that only the presence of allele G of the AKAP10 polymorphism was an independent risk factor for repolarization disturbances in the perioperative period (odds ratio =14.35; 95% CI =4.65-44.23; <0.0001).

CONCLUSION

When the acquired QTc interval prolongation or QTc dispersion is associated with AKAP10 polymorphism, it may remain clinically silent.

摘要

目的

我们旨在评估A激酶锚定蛋白10(AKAP10)基因多态性与高危血管手术患者获得性复极异常的易感性。

患者与方法

招募了100例计划接受择期高危“开放”血管手术的成年患者(年龄44 - 85岁)。使用心电图动态监测仪评估从手术开始至术后24小时的复极稳定性。分析AKAP10基因rs203462多态性与心脏并发症。

结果

46例患者记录到复极异常,定义为心率校正的QT间期(QTc)延长>500毫秒和QTc间期离散度>65毫秒。多因素逻辑回归模型显示,仅AKAP10基因多态性的G等位基因的存在是围手术期复极异常的独立危险因素(比值比 = 14.35;95%可信区间 = 4.65 - 44.23;<0.0001)。

结论

当获得性QTc间期延长或QTc离散度与AKAP10基因多态性相关时,可能在临床上无明显表现。

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