In:
Cardiology, S. Karger AG, Vol. 110, No. 1 ( 2008), p. 45-52
Abstract:
〈 i 〉 Background: 〈 /i 〉 Atrial fibrillation (AF) is a common arrhythmia encountered following cardiac surgery. Previously, we have shown that higher expression of heat shock protein (HSP) 70 was associated with decreased incidence of postoperative AF (PoAF), suggestive of an antiarrhythmic role. 〈 i 〉 Objective: 〈 /i 〉 We have hypothesised that Met493Thr substitution of one of the important 〈 i 〉 hsp 〈 /i 〉 70 genes may cause loss of these protective antiarrhythmic effects. We therefore set out to examine the influence of 〈 i 〉 hsp 〈 /i 〉 70 genotype on the incidence of PoAF. 〈 i 〉 Methods and Results: 〈 /i 〉 We prospectively recruited 244 Caucasian patients undergoing elective coronary artery bypass surgery. The median age was 65 years (40–80 years). PoAF was defined as the characteristic arrhythmia lasting for at least 15 min, occurring within first week following surgery and requiring treatment. This occurred in 48 patients (19.7%). Validated Met493Thr substitution in 〈 i 〉 hsp 〈 /i 〉 70-Hom was determined using established techniques. Of 244 patients, genotype was determined for 242 cases. The three genotypes (MM, MT, and TT) were present at frequencies of 0.66, 0.31, and 0.03, respectively, and were in Hardy-Weinberg equilibrium. In unifactorial analysis patients carrier or homozygous for 493Thr mutation had significantly higher incidence of PoAF (Pearson χ 〈 sup 〉 2 〈 /sup 〉 = 4.3, p = 0.037). Multivariate analysis confirmed the positive association of 〈 i 〉 hsp 〈 /i 〉 70-Hom with PoAF (OR, 2.43; p = 0.016) independent of age, sex, previous myocardial infarction, number of distal anastomoses, and duration of ventilation, respectively. Serum HSP70 was ranging from 0.74 to 31.91 ng/ml (median, 2.89) and was not correlated with PoAF. Presence of 493Thr mutation was also significantly correlated with higher levels of serum HSP70 (p 〈 i 〉 = 〈 /i 〉 0.009). 〈 i 〉 Conclusions: 〈 /i 〉 Our data show that a mutation in 〈 i 〉 hsp 〈 /i 〉 70-Hom gene is associated with higher incidence of PoAF. These findings are consistent with our previous results and may suggest that patients harbouring this substitution will have less endogenous myocardial protection against AF in stressful situations.
Type of Medium:
Online Resource
ISSN:
0008-6312
,
1421-9751
Language:
English
Publisher:
S. Karger AG
Publication Date:
2008
detail.hit.zdb_id:
1482041-9
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