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Hemodynamic Parameters and Heart Rate Variability during a Tilt Test in Relation to Gene Polymorphism of Renin‐Angiotensin and Serotonin System
Author(s) -
MITRO PETER,
MUDRÁKOVÁ KLAUDIA,
MIČKOVÁ HELENA,
DUDÁŠ JÁN,
KIRSCH PETER,
VALOČIK GABRIEL
Publication year - 2008
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2008.01228.x
Subject(s) - medicine , genotype , blood pressure , serotonin transporter , renin–angiotensin system , hemodynamics , endocrinology , gene polymorphism , angiotensin converting enzyme , heart rate variability , angiotensin ii , heart rate , polymorphism (computer science) , tilt table test , serotonin , biology , gene , genetics , receptor
Purpose: The aim of the study was to evaluate the renin‐angiotensin system and serotonin transporter gene polymorphisms in relation to hemodynamic parameters and heart rate variability during a head‐up tilt test (HUT) in patients with vasovagal syncope.Methods: DNA was collected from 191 patients (mean age 44 ± 18 years, 61 men, 130 women). The following gene polymorphisms were determined in genomic DNA: angiotensin‐converting enzyme insertion/deletion polymorphism (I/D ACE), angiotensinogen gene polymorphism (M 235), angiotensin II receptor type 1 (ATR1) polymorphism (A 11666C), and polymorphism of serotonin transporter gene (5HTTLPR).Heart rate variability during HUT was assessed in 5‐minute intervals by low frequency, high frequency, standard deviation of the normal‐to‐normal (SDNN), and root mean square successive difference parameters.Results: AA genotype of A 1166C polymorphism was associated with lower minimal systolic blood pressure (SBP) and diastolic blood pressure (DBP) during HUT compared with other genotypes (minimal SBP: AA 59.6 ± 21,8, AC 79.9 ± 22.7, CC 65.4 ± 22.7 mmHg, P = 0.007), (minimal DBP: AA 36.4 ± 22.7, AC 52.3 ± 22.9, CC 45.4 ± 19.5 mmHg, P = 0.007).AA genotype was also associated with higher SDNN compared to other genotypes in the early phase of HUT (SDNN in 5 minutes of tilt: AA 59.7 ± 24.6, AC 50.6 ± 20.6, CC 46.0 ± 13.2, P = 0.01) and at syncope occurrence (SDNN: AA 71.0 ± 20.9, AC 58.2 ± 17.9, CC 58 ± 10, P = 0.04)Conclusion: AA genotype of A 1166C polymorphism in the ATR1 gene may be associated with hypotension and decline in sympathetic tone during HUT. Its role in genetic predisposition to vasovagal syncope cannot be excluded.