韩国早发性心房颤动经导管消融术后患者单核苷酸多态性的影响。
The Effects of Single Nucleotide Polymorphisms in Korean Patients with Early-onset Atrial Fibrillation after Catheter Ablation.
机构信息
Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
出版信息
J Korean Med Sci. 2020 Dec 21;35(49):e411. doi: 10.3346/jkms.2020.35.e411.
BACKGROUND
This study evaluated the status of single nucleotide polymorphisms (SNPs) in Korean patients with early-onset (< 40 years old) atrial fibrillation (AF) and their effects on the outcome after catheter ablation.
METHODS
A total of 89 patients (35.7 ± 3.7 years, 81 males) with drug-refractory AF (paroxysmal 64.0%) who underwent catheter ablation were included in this study. Sixteen SNPs, including rs13376333, rs10465885, rs10033464, rs2200733, rs17042171, rs6843082, rs7193343, rs2106261, rs17570669, rs853445, rs11708996, rs6800541, rs251253, rs3807989, rs11047543, and rs3825214, were genotyped. Serial 48-hour Holter monitoring was conducted to detect AF recurrences during long-term follow up.
RESULTS
Wild-type genotypes of rs11047543 (GG; 26/69 [37.7%] vs. GA; 13/18 [72.2%] vs. AA; 0/0 [0%], = 0.009) and rs7193343 (CC; 0/7 [0%] vs. CT; 22/40 [55.0%] vs. TT; 18/41 [43.9%], = 0.025) and the homozygous variant of rs3825214 (AA; 16/31 [51.6%] vs. AG; 22/43 [51.2%] vs. GG; 2/13 [15.4%], = 0.056) were significantly associated with a lower rate of late recurrence. When the patients were assigned to four groups according to the number of risk alleles (n = 0-3), there were significant differences in recurrence rate (n = 0; 0/3 vs. n = 1; 2/13 [15.4%] vs. n = 2; 24/52 [46.2%] vs. n = 3; 13/17 [76.5%], = 0.003). When correcting for multiple variables, rs11047543 (hazard ratio [HR], 2.723; 95% confidence interval [CI], 1.358-5.461; = 0.005) and the number of risk alleles (HR, 2.901; 95% CI, 1.612-5.219; < 0.001) were significantly associated with recurrence of AF after catheter ablation.
CONCLUSION
Polymorphisms on rs7193343 closest to ZFHX3 (16q22), rs3825214 near to TBX5 (12q24), and rs11047543 near to SOX5 (12p12) modulate the risk for AF recurrence after catheter ablation. The number of risk alleles of these 3 SNPs was an independent predictor of recurrence during long-term follow up in Korean patients with early-onset AF.
背景
本研究评估了韩国早发性（<40 岁）心房颤动（AF）患者单核苷酸多态性（SNP）的状况及其对导管消融后结局的影响。
方法
本研究共纳入 89 例药物难治性 AF 患者（阵发性 64.0%）接受导管消融治疗，这些患者的年龄为（35.7±3.7）岁，其中 81 例为男性。包括 rs13376333、rs10465885、rs10033464、rs2200733、rs17042171、rs6843082、rs7193343、rs2106261、rs17570669、rs853445、rs11708996、rs6800541、rs251253、rs3807989、rs11047543 和 rs3825214 在内的 16 个 SNP 进行了基因分型。在长期随访期间，通过连续 48 小时 Holter 监测检测 AF 复发。
结果
rs11047543（GG；26/69[37.7%]vs.GA；13/18[72.2%]vs.AA；0/0[0%]， = 0.009）和 rs7193343（CC；0/7[0%]vs.CT；22/40[55.0%]vs.TT；18/41[43.9%]， = 0.025）野生型基因型和 rs3825214（AA；16/31[51.6%]vs.AG；22/43[51.2%]vs.GG；2/13[15.4%]， = 0.056）与晚期复发率较低显著相关。当根据风险等位基因数量（n = 0-3）将患者分为四组时，复发率存在显著差异（n = 0；0/3 vs.n = 1；2/13[15.4%]vs.n = 2；24/52[46.2%]vs.n = 3；13/17[76.5%]， = 0.003）。在对多个变量进行校正后，rs11047543（危险比[HR]，2.723；95%置信区间[CI]，1.358-5.461； = 0.005）和风险等位基因数量（HR，2.901；95%CI，1.612-5.219；<0.001）与导管消融后 AF 复发显著相关。
结论
与 ZFHX3（16q22）最接近的 rs7193343、与 TBX5（12q24）最接近的 rs3825214 以及与 SOX5（12p12）最接近的 rs11047543 上的多态性调节了导管消融后 AF 复发的风险。这 3 个 SNP 的风险等位基因数量是韩国早发性 AF 患者长期随访中复发的独立预测因子。
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