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Aim   To investigate the genetic contribution of adenosine A3 receptor (ADORA3) gene polymorphisms in the pathogenesis of chronic heart failure (CHF).Methods   Firstly, a case-control study was performed to investigate the association of ADORA3 polymorphisms with CHF risk. Three hundred northern Chinese Han CHF patients and 400 ethnicity-matched healthy controls were included. Four polymorphisms were genotyped. This case-control study was also replicated in 304 CHF patients and 402 controls from southern China. Finally, the functional variability of positive polymorphism was analyzed using luciferase reporter assay and real-time PCR.Results   Overall, the rs1544223 was significantly associated with CHF risk under the dominant model ( P  = 0.046, OR = 1.662, 95% CI = 1.009–2.738). But it did not affect disease severity. These results were also consistent in replicated population. In addition, the transcriptional activity for promoter with the A allele was lower than that with the G allele ( n  = 3, 4.501 ± 0.308 versus 0.571 ± 0.114,  P  < 0.01) and ADORA3 mRNA levels were significantly higher in GG homozygotes than subjects carrying GA ( n  = 6, 0.058 ± 0.01 versus 0.143 ± 0.068,  P  = 0.004) or AA genotypes ( n  = 6, 0.065 ± 0.01 versus 0.143 ± 0.068,  P  = 0.008).Conclusions   Should the findings be validated by further studies with larger patient samples and in different ethnicities, they may provide novel insight into the pathogenesis of CHF.

The Polymorphism in ADORA3 Decreases Transcriptional Activity and Influences the Chronic Heart Failure Risk in the Chinese