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LDB3 基因多态性对中国特发性扩张型心肌病患者临床表型及植入式心脏复律除颤器(ICD)植入的影响。

Impact of LDB3 gene polymorphisms on clinical presentation and implantable cardioverter defibrillator (ICD) implantation in Chinese patients with idiopathic dilated cardiomyopathy.

机构信息

Department of Cardiology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.

Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.

出版信息

J Zhejiang Univ Sci B. 2019;20(9):766-775. doi: 10.1631/jzus.B1900017.

Abstract

OBJECTIVE

Mutations in LIM domain binding 3 (LDB3) gene cause idiopathic dilated cardiomyopathy (IDCM), a structural heart disease with a complicated genetic background. However, the association of polymorphisms in the LDB3 gene with susceptibility to IDCM in Chinese populations remains unexplored as dose the impact on clinical presentation.

METHODS

We sequenced all exons and the adjacent part of introns of the LDB3 gene in 159 Chinese Han IDCM patients and 247 healthy controls. Then we detected the distribution of polymorphisms in the LDB3 gene in all participants and assessed their associations with risk of IDCM. Additionally, we conducted a stratified genotype-phenotype correlation analysis.

RESULTS

The A allele of rs4468255 was significantly associated with IDCM (P<0.01). The rs4468255, rs11812601, rs56165849, and rs3740346 were also associated with diastolic blood pressure (DBP) and left ventricular ejection fraction (LVEF) (P<0.05). Notably, a higher frequency of rs4468255 polymorphism was observed in implantable cardioverter defibrillator (ICD) recipients under a recessive model (P<0.01), whereas the significant association disappeared after adjusting for potential confounders. However, in the dominant model, notable correlations could only be observed after adjusting for multi parameters.

CONCLUSIONS

The rs4468255 was significantly correlated with IDCM of Chinese Han population. A allele of rs4468255 is higher in IDCM patients with ICD implantation, suggesting the influence of genetic background in the generation of this response. In addition, rs11812601, rs56165849, and rs3740346 in LDB3 show association with brain natriuretic peptide, DBP, and LVEF levels in patients with IDCM but did not show any association with IDCM susceptibility.

摘要

目的

LIM 结构域结合蛋白 3(LDB3)基因突变可导致特发性扩张型心肌病(IDCM),这是一种具有复杂遗传背景的结构性心脏病。然而,LDB3 基因多态性与中国人群 IDCM 易感性的关联以及对临床表型的影响尚未得到探索。

方法

我们对 159 例汉族 IDCM 患者和 247 名健康对照者的 LDB3 基因所有外显子及其相邻内含子进行测序。然后,我们检测了所有参与者中 LDB3 基因多态性的分布,并评估了它们与 IDCM 风险的相关性。此外,我们还进行了分层基因型-表型相关性分析。

结果

rs4468255 的 A 等位基因与 IDCM 显著相关(P<0.01)。rs4468255、rs11812601、rs56165849 和 rs3740346 也与舒张压(DBP)和左心室射血分数(LVEF)相关(P<0.05)。值得注意的是,在隐性模型下,ICD 植入患者的 rs4468255 多态性频率更高(P<0.01),但在调整潜在混杂因素后,这种显著相关性消失。然而,在显性模型下,只有在调整多参数后才能观察到明显的相关性。

结论

rs4468255 与中国汉族人群的 IDCM 显著相关。rs4468255 的 A 等位基因在接受 ICD 植入的 IDCM 患者中更高,提示遗传背景对这种反应的影响。此外,LDB3 中的 rs11812601、rs56165849 和 rs3740346 与 IDCM 患者的脑钠肽、DBP 和 LVEF 水平相关,但与 IDCM 易感性无关。

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