Abstract
AimsThe risk stratification of patients for heart failure (HF) remains a challenge, as well as the anticipation of the response to β-blocker therapy. Since the pivotal role of β1 adrenergic receptor (β1-AR) in HF, many publications have studied the associations between the β1-AR polymorphisms (Ser49Gly and Arg389Gly) and HF, with inconsistent results. Thus, we performed a meta-analysis of studies to evaluate the impact of β1-AR polymorphisms on susceptibility to HF, the response to β-blocker therapy and the prognosis of HF.Methods and ResultsElectronic databases were systematically searched before August 2011. We extracted data sets and performed meta-analysis with standardized methods. A total of 27 studies met our inclusion criteria. It was found that in East Asians, the Gly389 allele and Gly389 homozygotes significantly increased the HF risk, while the Gly389 allele and Gly389 homozygotes trended to decrease the risk of HF in whites. With the similar reduction of heart rate, overall, the Arg389 homozygotes showed a better response to β-blocker therapy. Furthermore, the Arg389 homozygotes were significantly associated with better LVEF improvement in East Asians and a mixed population. And in white people, the Arg389 homozygotes made a greater LVESd/v improvement and trended to be associated with better LVEDd/v improvement. However, the prognosis of Arg389 homozygotes HF patients was similar to those with Gly389 carriers. The Ser49Gly polymorphism did not impact the risk or prognosis of HF.ConclusionBased on our meta-analysis, the Gly389 allele and Gly389 homozygotes were risk factors in East Asians while trending to protect whites against HF. Furthermore, Arg389 homozygote is significantly associated with a favorable response to β-blocker treatment in HF patients. However, neither of the two polymorphisms is an independent predictor of the prognosis of HF.
Highlights
IntroductionHeart failure (HF) is the end-stage of various heart diseases, and it represents a major health problem owing to its high prevalence, morbidity, mortality and significant health-care costs [1,2]. bblockers are mainstay of current treatment of heart failure (HF) in guideline, for their administration has beneficial effects on left ventricular (LV) function and prognosis [1,2,3,4,5,6,7]
Arg389 homozygote is significantly associated with a favorable response to b-blocker treatment in heart failure (HF) patients
Neither of the two polymorphisms is an independent predictor of the prognosis of HF
Summary
Heart failure (HF) is the end-stage of various heart diseases, and it represents a major health problem owing to its high prevalence, morbidity, mortality and significant health-care costs [1,2]. bblockers are mainstay of current treatment of heart failure (HF) in guideline, for their administration has beneficial effects on left ventricular (LV) function and prognosis [1,2,3,4,5,6,7]. There are needs for risk stratification tools of HF and predictors of response to b-blockers treatment, which are still challenges in the real world. Two common functional polymorphisms of the b1-AR, Ser49Gly and Arg389Gly have been considered as predictors of susceptibility to HF, response to b-blockers therapy and even prognosis of HF in some publications. Being limited by small sample size, the results are controversial We performed this meta-analysis of all the available studies to evaluate the impacts of b1 AR polymorphisms on susceptibility to HF, response to b-blocker therapy, and prognosis. It may provide information for further investigation on individualized HF prevention and treatment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
