Atici Adem, Rasih-Sonsoz Mehmet, Ali-Barman Hasan, Durmaz Eser, Demirkiran Ahmet, Gulsen Kamil, Elitok Ali, Onur Imran, Sahin Irfan, Kaya Bilge Ahmet
Cardiology Department of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
Rev Invest Clin. 2020 May 7;72(5). doi: 10.24875/RIC.20003319.
Vasovagal syncope (VVS) is a common clinical condition involving genetic background. The role of beta-blockers in the treatment is controversial.
The aim of this study was to investigate the effect of beta-1 gene polymorphism on beta-blocker therapy in patients with VVS.
We included 123 patients who were diagnosed with VVS after the tilttable test. We searched for the polymorphism Arg389Gly (rs1801253) in the beta-1 adrenoceptor gene.
Overall, 64 patients (52%) had Arg389Arg with Arg389Arg genotype were more frequent compared with patients having Arg389Gly genotype (total syncopal episodes [TSE], 7.9 ± 3.7 vs. 6.4 ± 3.0; p = 0.012). TSE in patients with Arg389Arg genotype decreased significantly after 18 months of beta-blocker treatment (7.9 ± 3.7 vs. 3.0 ± 1.4, p < 0.001). After 18 months of beta-blocker treatment, patients with Arg389Arg genotype had significantly fewer syncopal episodes than patients with Arg389Gly genotype (3.0 ± 1.4 vs. 6.8 ± 3.2, p < 0.001).
Results of beta-blocker therapy in patients with Arg389Arg genotype suggest that VVS pathophysiology is a multifactorial condition, with genetic, psychological, and environmental components, and therefore, treatment selection can be based on gene polymorphism.
血管迷走性晕厥（VVS）是一种涉及遗传背景的常见临床病症。β受体阻滞剂在治疗中的作用存在争议。
本研究旨在探讨β-1基因多态性对VVS患者β受体阻滞剂治疗效果的影响。
我们纳入了123例在倾斜试验后被诊断为VVS的患者。我们在β-1肾上腺素能受体基因中寻找Arg389Gly（rs1801253）多态性。
总体而言，64例患者（52%）为Arg389Arg，与具有Arg389Gly基因型的患者相比，Arg389Arg基因型更为常见（总晕厥发作次数[TSE]，7.9±3.7对6.4±3.0；p = 0.012）。β受体阻滞剂治疗18个月后，Arg389Arg基因型患者的TSE显著降低（7.9±3.7对3.0±1.4，p < 0.001）。β受体阻滞剂治疗18个月后，Arg389Arg基因型患者的晕厥发作次数明显少于Arg389Gly基因型患者（3.0±1.4对6.8±3.2，p < 0.001）。
Arg389Arg基因型患者的β受体阻滞剂治疗结果表明，VVS的病理生理学是一种多因素病症，具有遗传、心理和环境因素，因此，治疗选择可基于基因多态性。
