Open AccessPossible genetic implications in the response to cardiac resynchronisation therapy in a patient affected by heart failure
Author(s) -
Natalia Pezzali,
Marco Metra,
Livio Dei
Publication year - 2011
Publication title -
clinical management issues
Language(s) - English
Resource type - Journals
eISSN - 2283-3137
pISSN - 1973-4832
DOI - 10.7175/cmi.v5i2.507
Subject(s) - medicine , cardiology , ejection fraction , heart failure , qrs complex , ventricular tachycardia , implantable cardioverter defibrillator , cardiomyopathy , dilated cardiomyopathy , genotyping , tachycardia , genotype , gene , biochemistry , chemistry
This report presents a case of a patient with idiopathic dilated cardiomyopathy and severe left ventricular systolic dysfunction who underwent cardiac resynchronisation therapy (CRT). During the follow-up a progressive increase in left ventricular ejection fraction was observed, as well as clinical improvement. No cardiovascular events occurred during the follow-up, except for appropriate Implantable Cardioverter Defibrillator (ICD) bursts for fast ventricular tachycardia. Genotyping for adrenoceptor gene polymorphisms detected that the patient was Glu27Glu homozygous carrier. There’s a large interindividual variability in response to CRT. Despite attempts to identify factors having an impact on this therapy, only QRS duration is accepted according to guidelines. Beta-adrenoceptors polymorphisms, modulating sympathetic drive in heart failure and left ventricular remodelling, may have a role in identifying patients with a better response to CRT, in order to target and individualise the patients’ treatment