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Common genetic variants in selected Ca2+ signaling genes and the risk of appropriate ICD interventions in patients with heart failure

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Defective Ca2+ handling in failing cardiomyocites predisposes patients with heart failure (HF) to ventricular arrhythmia. We investigated whether gene variants of Ca2+ handling proteins are associated with the occurrence of ventricular tachycardia/fibrillation (VT/VF) in HF patients implanted with a primary prevention implantable cardioverter-defibrillator (ICD).

Methods

One hundred thirty-six patients with HF were followed from ICD implantation to the time of first appropriate ICD intervention for VT > 170 bpm. The following polymorphisms were genotyped: ATP2A2 rs1860561 and rs56243033; RYR2 rs4142933; CASQ2 rs4074536; SLC8A1 g.-23449C > A; PLN rs12198461; FKBP1B rs7568163. Hazard ratios (HR) were derived from Cox proportional-hazards regression analysis.

Results

After a mean follow-up of 879 days (IQ range, 327 to 1,459), 34 patients (25 %) had appropriate ICD intervention. Non-sustained VT (HR, 2.12; 95 %CI, 0.87–5.19; p = 0.09) and atrial fibrillation (AF) at ICD implantation (HR, 2.33; 95 %CI, 0.89–6.10; p = 0.08) predicted appropriate ICD interventions with borderline statistical significance. Prevalence of ATP2A2 rs1860561 variant was 17 % in patients without VT/VF and 4 % in those with ventricular arrhythmia (p = 0.009). After adjustment for AF and NSVT, the rs1860561 A mutant allele independently predicted lower incidence of VT/VF (HR, 0.29; 95 %CI, 0.09–0.98; p = 0.04).

Conclusions

The observation that ATP2A2 rs1860561 gene variant associated with lower risk of life-threatening arrhythmia in HF patients suggests that selected calcium gene variants may modify the risk of SD even within the complex and polygenic pathological condition of HF. Combining traditional risk factors and genetic profiling could reveal helpful to identify HF patients who will benefit most from ICD implantation.

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Sources of funding

This work was supported by a grant (Ricerca Corrente) from the Italian Ministry of Health to MV and SR; by the 5 ‰ grant to MV and SR; by PRIN 2009 to SR; by Ingenious HyperCare European Project to MV; by a grant from University Sapienza to PF.

Conflicts of interest

None declared

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Clinical and Molecular Medicine, Sapienza University of Rome Sant’Andrea Hospital, Via di Grottarossa, 00189, Rome, Italy

    Pietro Francia, Carmen Adduci, Agnese Ricotta, Isabella Sensini, Arianna Uccellini, Alessandra Frattari, Cristina Balla, Speranza Rubattu & Massimo Volpe

  2. I.R.C.C.S. Neuromed, Pozzilli, IS, Italy

    Rosita Stanzione, Maria Cotugno, Speranza Rubattu & Massimo Volpe

  3. Arrhythmia and Electrophysiology Centre, I.R.C.C.S. San Donato, San Donato Milanese, MI, Italy

    Riccardo Cappato

Authors
  1. Pietro Francia
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  2. Carmen Adduci
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  3. Agnese Ricotta
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  4. Rosita Stanzione
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  5. Isabella Sensini
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  6. Arianna Uccellini
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  7. Alessandra Frattari
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  8. Cristina Balla
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  11. Speranza Rubattu
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  12. Massimo Volpe
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Correspondence to Pietro Francia.

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Francia, P., Adduci, C., Ricotta, A. et al. Common genetic variants in selected Ca2+ signaling genes and the risk of appropriate ICD interventions in patients with heart failure. J Interv Card Electrophysiol 38, 169–177 (2013). https://doi.org/10.1007/s10840-013-9827-1

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  • DOI: https://doi.org/10.1007/s10840-013-9827-1

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