Pharmacogenetics of Heart Failure: Evidence, Opportunities, and Challenges for Cardiovascular Pharmacogenomics

  • Matthew T. Wheeler
  • Michael Ho
  • Joshua W. Knowles
  • Aleks Pavlovic
  • Euan A. Ashley


Heart failure is a significant medical problem affecting more than five million people in the USA alone. Although clinical trials of pharmacological agents have demonstrated significant reductions in the relative risk of mortality across populations, absolute mortality remains high. In addition, individual variation in response is great. Some of this variation may be explained by genetic polymorphism. In this paper, we review the key studies to date in heart failure pharmacogenetics, setting this against a background of recent progress in the genetics of warfarin metabolism. Several polymorphisms that have supporting molecular and clinical data in the heart failure literature are reviewed, among them the β1-adrenergic receptor variant Arg389Gly and the angiotensin converting enzyme gene insertion/deletion polymorphism. These variants and others are responsible for a fraction of the total variation seen in the treatment response to heart failure. With the dawn of the genomic age, further pharmacogenetic and new pharmacogenomic studies will advance our ability to tailor the treatment of heart failure.


Pharmacogenetics Pharmacogenomics Heart Failure Beta Blockers ACE Inhibitors Warfarin Aldosterone ADRB1 ADRB2 ADRA2C VKORC1 CYP11B2 CYP2C9 


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Copyright information

© Springer 2008

Authors and Affiliations

  • Matthew T. Wheeler
    • 1
  • Michael Ho
    • 1
  • Joshua W. Knowles
    • 1
  • Aleks Pavlovic
    • 1
  • Euan A. Ashley
    • 1
  1. 1.Division of Cardiovascular Medicine, Department of MedicineStanford UniversityStanfordUSA

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