Scientific Laboratory of Molecular Genetics, Rīga Stradiņš University, 16 Dzirciema Str., LV-1007 Rīga, Latvia.
Latvian Cardiology Center, Pauls Stradiņš Clinical University Hospital, Pilsoņu iela 13, Zemgales priekšpilsēta, LV-1002 Rīga, Latvia.
Medicina (Kaunas). 2021 Nov 18;57(11):1263. doi: 10.3390/medicina57111263.
: Recurrence of atrial fibrillation (AF) within six months after sinus rhythm restoration with direct current cardioversion (DCC) is a significant treatment challenge. Currently, the factors influencing outcome are mostly unknown. Studies have found a link between genetics and the risk of AF and efficacy of rhythm control. The aim of this study was to examine the association between eight single-nucleotide variants (SNVs) and the risk of AF development and recurrence after DCC. Regarding the occurrence of AF, 259 AF cases and 108 controls were studied. Genotypes for the eight SNVs located in the genes , , , , , and were determined using high-resolution melting analysis and confirmed with Sanger sequencing. Six months after DCC, a telephone interview was conducted to determine whether AF had recurred. A polygenic risk score (PRS) was calculated as the unweighted sum of risk alleles. Multivariate regression analyses were performed to assess SNV and PRS association with AF occurrence and recurrence after DCC. The risk allele of rs2200733 () was significantly associated with the development of AF ( = 0.012, OR = 2.31, 95% CI = 1.206-4.423). AF recurred in 60% of patients and the allele generally associated with a decreased risk of AF of rs11047543 () was associated with a greater risk of AF recurrence ( = 0.014, OR = 0.223, 95% CI = 0.067-0.738). A PRS of greater than 7 was significantly associated ( = 0.008) with a higher likelihood of developing AF after DCC (OR = 4.174, 95% CI = 1.454-11.980). : A higher PRS is associated with increased odds of AF recurrence after treatment with DCC. (rs2200733) is significantly associated with an increased risk of AF. The protective allele of rs11047543 () is associated with a greater risk of AF recurrence. Further studies are needed to predict the success of rhythm control and guide patient selection towards the most efficacious treatment.
: 直流电复律（DCC）恢复窦性心律后 6 个月内心房颤动（AF）的复发是一个重大的治疗挑战。目前，影响结果的因素大多未知。研究发现遗传学与 AF 的风险和节律控制的疗效之间存在联系。本研究旨在研究 8 个单核苷酸变异（SNV）与 DCC 后 AF 发生和复发风险之间的关系。关于 AF 的发生，研究了 259 例 AF 病例和 108 例对照。使用高分辨率熔解分析确定位于基因、、、、、和中的 8 个 SNV 的基因型，并通过 Sanger 测序进行确认。DCC 后 6 个月，通过电话访谈确定 AF 是否复发。计算多基因风险评分（PRS）作为风险等位基因的无权重和。进行多变量回归分析，以评估 SNV 和 PRS 与 DCC 后 AF 发生和复发的关系。rs2200733（）的风险等位基因与 AF 的发生显著相关（=0.012，OR=2.31，95%CI=1.206-4.423）。60%的患者出现 AF 复发，与 rs11047543（）的 AF 风险降低相关的等位基因与 AF 复发的风险增加相关（=0.014，OR=0.223，95%CI=0.067-0.738）。PRS 大于 7 与 DCC 后 AF 发生的可能性显著相关（=0.008）（OR=4.174，95%CI=1.454-11.980）。结论：PRS 较高与 DCC 治疗后 AF 复发的几率增加相关。rs2200733（）与 AF 风险增加显著相关。rs11047543（）的保护性等位基因与 AF 复发风险增加相关。需要进一步的研究来预测节律控制的成功率，并指导患者选择最有效的治疗方法。
