The role of polymorphisms in genes that regulate neurohumoral systems in patients with atrial fibrillation

Authors

  • I. M. Fushtei State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine”,
  • S. H. Podluzhnyi Municipal Institution “Zaporizhzhia Municipal Clinical Hospital No.10”, Ukraine,
  • Ye. V. Sid State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of Ministry of Health of Ukraine”,

DOI:

https://doi.org/10.14739/2310-1210.2019.3.169201

Keywords:

genetic polymorphism, atrial fibrillation, renin-angiotensin-aldosterone system, catecholamines, NO synthase

Abstract

 

One of the important medical and social present-day problems is atrial fibrillation (AF) which prevalence in the adult population is 2 % for persons under 65 and 9 % for those over 65 years of age and it is a common cause of ischemic stroke. The embolic complications incidence is 2.1 % per year in patients with paroxysmal AF, and 3.0 % per year in patients with persistent AF.

The aim of the study is to analyze the modern literary sources related to the role of gene polymorphisms regulating some neurohumoral systems in group of patients with atrial fibrillation.

A combination of certain genes polymorphisms can contribute to AF risk. Especially important are gene studies of the renin-angiotensin-aldosterone system (RAAS) role in the pathogenesis of AF which are currently being studied with a particular intensity. Recent data show that activation of RAAS plays an important role in the development and recurrence of AF. These studies are of great practical interest as the associative effect of angiotensin converting enzyme (ACE) inhibitors in the prevention of AF has been identified.

AGT gene encodes a plasma protein known as angiotensinogen. This protein is expressed in the liver and is cleaved by the enzymatic renin action in response to lower blood pressure. The resulting product, angiotensin I, is then cleaved by ACE to the physiologically active enzyme angiotensin II. Defects in this gene may also be associated with non-hereditary AF. More than 16 spot mutations in the AGT gene were discovered, most of which resulted in amino acid substitutions.

Conclusions. The analysis of the literature allows to conclude that, first, genetic polymorphisms may influence both the severity of pathological changes in the body and the efficacy of pharmacotherapy, and second, the study of RAAS gene polymorphisms may allow early detection of persons with increased risk of persistent AF recurrence and its prevention.

 

References

January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cigarroa, J. E., Conti, J. B., et al. (2014). 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 64(21), e1–e76. doi: 10.1016/j.jacc.2014.03.022

Vanassche, T., Lauw, M. N., Eikelboom, J. W., Healey, J. S., Hart, R. G., Alings, M., et al. (2015). Risk of ischaemic stroke according to pattern of atrial fibrillation: analysis of 6563 aspirin-treated patients in ACTIVE-A and AVERROES. European heart journal, 36(5), 281–288. doi: 10.1093/eurheartj/ehu307

Popova, E. P., & Fisenko, V. P. (2017). Fibrillyaciya predserdij: mekhanizmy razvitiya i lekarstvennaya terapiya [Atrial fibrillation: mechanisms of development and drug therapy]. E'ksperimental'naya i klinicheskaya farmakologiya, 80(4), 34–44. [in Russian]. doi: 10.30906/0869-2092-2017-80-4-34-44

Kuskaeva, A. V., Nikulina, S. Yu., Chernova, A. A., & Aksyutina, N. V. (2016). Geneticheskie prediktory fibrillyacii predserdij [Genetic predictors of atrial fibrillation]. Racional'naya farmakoterapiya v kardiologii, 12(3), 331–336. [in Russian]. doi: http://dx.doi.org/10.20996/1819-6446-2016-12-3-331-336

Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., et al. (2016). 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J, 37(38), 2893–2962. doi: 10.1093/eurheartj/ehw210

Iravanian, S., & Dudley Jr, S. C. (2008). The renin-angiotensin-aldosterone system (RAAS) and cardiac arrhythmias. Heart rhythm, 5(6), S12–S17. doi: 10.1016/j.hrthm.2008.02.025

Ehrlich, J. R., Hohnloser, S. H., & Nattel, S. (2005). Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence. European heart journal, 27(5), 512–518. doi: 10.1093/eurheartj/ehi668

Jalife, J. (2014). Mechanisms of persistent atrial fibrillation. Current opinion in cardiology, 29(1), 20–27. doi: 10.1097/HCO.0000000000000027

Topal, N. P., Ozben, B., Hancer, V. S., Tanrikulu, A. M., Diz-Kucukkaya, R., Fak, A. S., et al. (2011). Polymorphisms of the angiotensin-converting enzyme and angiotensinogen gene in patients with atrial fibrillation. Journal of the Renin-Angiotensin-Aldosterone System, 12(4), 549–556. doi: 10.1177/1470320311399605

Wang, Q., Hu, X., Li, S., Wang, X., Wang, J., Zhang, R., et al. (2015). Association of the angiotensinogen M235T polymorphism with recurrence after catheter ablation of acquired atrial fibrillation. Journal of the Renin-Angiotensin-Aldosterone System, 16(4), 888–897. doi: 10.1177/1470320315594315

Boldt, A., Wetzel, U., Weigl, J., Garbade, J., Lauschke, J., Hindricks, G., et al. (2003). Expression of angiotensin II receptors in human left and right atrial tissue in atrial fibrillation with and without underlying mitral valve disease. Journal of the American College of Cardiology, 42(10), 1785–1792.

Mehta, P. K., & Griendling, K. K. (2007). Angiotensin II cell signaling: physiological and pathological effects in the cardiovascular system. American Journal of Physiology-Cell Physiology, 292(1), C82–C97. doi: 10.1152/ajpcell.00287.2006

Bonnardeaux, A., Davies, E., Jeunemaitre, X., Fery, I., Charru, A., Clauser, E., et al. (1994). Angiotensin II type 1 receptor gene polymorphisms in human essential hypertension. Hypertension, 24(1), 63–69.

Belenkov, Y. N., Privalova, E. V., Kaplunova, V. Y., Stambol'skiĭ, D. V., & Fomin, A. A. (2010). Analysis of morpho-functional parameters of the heart and polymorphisms of Renin-Angiotensin-aldosterone system genes in patients with different variants of the course of hypertrophic cardiomyopathy. Kardiologiia, 50(6), 27–34.

van Geel, P. P., Pinto, Y. M., Buikema, H., & van Gilst, W. H. (1998). Is the A1166C polymorphism of the angiotensin II type 1 receptor involved in cardiovascular disease? European heart journal, 19, G13–7.

Van Geel, P. P., Pinto, Y. M., Voors, A. A., Buikema, H., Oosterga, M., Crijns, H. J., & van Gilst, W. H. (2000). Angiotensin II type 1 receptor A1166C gene polymorphism is associated with an increased response to angiotensin II in human arteries. Hypertension, 35(3), 717–721. doi: 10.1161/01.HYP.35.3.717

Belluzzi, F., Sernesi, L., Preti, P., Salinaro, F., Fonte, M. L., & Perlini, S. (2009). Prevention of recurrent lone atrial fibrillation by the angiotensin-II converting enzyme inhibitor ramipril in normotensive patients. Journal of the American College of Cardiology, 53(1), 24–29. doi: 10.1016/j.jacc.2008.08.071

Tayebjee, M. H., Creta, A., Moder, S., Hunter, R. J., Earley, M. J., Dhinoja, M. B., & Schilling, R. J. (2010). Impact of angiotensin-converting enzyme-inhibitors and angiotensin receptor blockers on long-term outcome of catheter ablation for atrial fibrillation. Europace, 12(11), 1537–1542. doi: 10.1093/europace/euq284

Healey, J. S., Baranchuk, A., Crystal, E., Morillo, C. A., Garfinkle, M., Yusuf, S., & Connolly, S. J. (2005). Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis. Journal of the American College of Cardiology, 45(11), 1832–1839. doi: 10.1016/j.jacc.2004.11.070

Chapurnykh, A. (2012). β-Adrenoblokatory v lechenii aritmii [β-Adrenoblockers in the Treatment of Arrythmias]. Kardiologiya, 52(6), 86–92. [in Russian].

Pacanowski, A. M. (2007). Johnson JA ADRB1 Gene Summary. Pharmacological Reviews, 59(1), 2–4.

Parvez, B., Chopra, N., Rowan, S., Vaglio, J. C., Muhammad, R., Roden, D. M., & Darbar, D. (2012). A common β1-adrenergic receptor polymorphism predicts favorable response to rate-control therapy in atrial fibrillation. Journal of the American College of Cardiology, 59(1), 49–56. doi: 10.1016/j.jacc.2011.08.061

Nia, A. M., Caglayan, E., Gassanov, N., Zimmermann, T., Aslan, O., Hellmich, M., et al. (2010). Beta1-adrenoceptor polymorphism predicts flecainide action in patients with atrial fibrillation. PLoS One, 5(7), e11421. doi: 10.1371/journal.pone.0011421

Nicoulina, S., Shulman, V., Shesternya, P., Chernova, A., Salmina, A., Issachenko, O., et al. (2010). Association of ADRB1 gene polymorphism with atrial fibrillation. Genetic testing and molecular biomarkers, 14(2), 249–253. doi: 10.1089/gtmb.2009.0100

Vecoli, C. (2014). Endothelial nitric oxide synthase gene polymorphisms in cardiovascular disease. In Vitamins & Hormones, 96, 387–406. doi: 10.1016/B978-0-12-800254-4.00015-5

Tovazhnyanskaya, E. L. (2016). E'ndotelial'naya disfunkciya. Klinicheskie aspekty problemy i puti ee resheniya [Endothelial dysfunction. Clinical aspects of the problem and ways to solve it]. Zhurnal nevrologіi іm. B.M. Man'kovs'kogo, 3, 17–21. [in Russian].

Casas, J. P., Cavalleri, G. L., Bautista, L. E., Smeeth, L., Humphries, S. E., & Hingorani, A. D. (2006). Endothelial nitric oxide synthase gene polymorphisms and cardiovascular disease: a HuGE review. American journal of epidemiology, 164(10), 921–935. doi: 10.1093/aje/kwj302

Pal, G. K., Adithan, C., Umamaheswaran, G., Pal, P., Nanda, N., Indumathy, J., & Syamsunder, A. N. (2016). Endothelial nitric oxide synthase gene polymorphisms are associated with cardiovascular risks in prehypertensives. Journal of the American Society of Hypertension, 10(11), 865–872. doi: 10.1016/j.jash.2016.09.001

Hasanzad, M., Imeni, M., & Mohammadhasani, M. R. (2014). Genetic polymorphism of endothelial nitric oxide synthase in coronary artery disease. Intern. Heart Vasc. Dis. J, 2(2), 32–36.

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Fushtei IM, Podluzhnyi SH, Sid YV. The role of polymorphisms in genes that regulate neurohumoral systems in patients with atrial fibrillation. Zaporozhye Medical Journal [Internet]. 2019May31 [cited 2024Jun.18];(3). Available from: http://zmj.zsmu.edu.ua/article/view/169201

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