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The impact of beta‐adrenoreceptor gene polymorphisms on survival in patients with congestive heart failure *
Author(s) -
Groote Pascal,
Lamblin Nicolas,
Helbecque Nicole,
Mouquet Frédéric,
Mc Fadden Eugène,
Hermant Xavier,
Amouyel Philippe,
Dallongeville Jean,
Bauters Christophe
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.10.006
Subject(s) - medicine , ejection fraction , heart failure , cardiology , creatinine , atrial fibrillation , prospective cohort study , radionuclide angiography , angiotensin converting enzyme , blood pressure
Objective: Discordant results have been published regarding a possible association between beta‐adrenoreceptor (βAR) gene polymorphisms and survival in patients with congestive heart failure (CHF). The aim of the study was to analyze the impact of five functional βAR gene polymorphisms in patients with stable CHF. Methods: We prospectively studied 444 consecutive patients with CHF related to left ventricular systolic dysfunction. The β 1 ARSer49Gly, β 1 ARGly389Arg, β 2 AR Arg16Gly, β 2 AR Gln27Glu and β 2 AR Thr164Ile polymorphisms were determined. Patients underwent echocardiography, radionuclide angiography and a cardiopulmonary exercise test. Results: Mean age was 56.6±11.9 years old, left ventricular ejection fraction (LVEF) was 32±12%, and peak VO2 was 15.5±4.9 ml/min/kg or 63±18% of maximal predicted VO2. Most of the patients (95%) were receiving angiotensin converting enzyme inhibitors and 91% β‐blockers. There was no statistically significant differences between baseline characteristics among β 1 AR and β 2 AR genotypes. During a median follow‐up period of 1232 days, there were 110 cardiac‐related deaths and five urgent transplantations. Independent predictors of survival were percent (%) of maximal predicted VO2 ( p <0.0001), age ( p <0.0001), LVEF ( p =0.004), creatinine ( p =0.02) and atrial fibrillation ( p =0.04). No βAR polymorphisms were associated with survival. However, patients with the combined β 2 ARGly16Gly/β 2 ARGln27Gln genotype, who express receptors highly sensitive to down‐regulation, had a significantly lower survival rate than patients with other genotypes but only in univariate analysis. Conclusions: In this prospective study, we found no association between five functional βAR polymorphisms and survival in patients with stable CHF. However, we demonstrated, only in univariate analysis, a possible association between the combined β 2 ARGly16Gly/β 2 ARGln27Gln genotype and survival.