Impact of Beta adrenergic receptors polymorphism on the onset of ventricular fibrillation during the acute phase of myocardial infarction

Abstract

Ventricular fibrillation complicating acute myocardial ischemia is the main cause of sudden cardiac death. We investigated whether two known ADBR2 and ADRB1 polymorphisms are associated with ventricular fibrillation (VF) in the context of myocardial infarction (MI). A total of 831 patients were recruited during the MAP-IDM study: 392 patients who experienced VF during the acute phase of primary MI and 439 controls with MI without VF. Patients were genotyped for the ADRB2 Gln27Glu, the ADRB1 Arg389Gly polymorphisms by RT-PCR. Unconditional logistic regression models were fitted, after adjustment on center, age and sex. Age was included as a 5 age-group variable (27–44, 45–54, 55–64, 65–74, 75–88) using dummy variables, including interaction terms between sex and age-groups. Cases and controls did not differ significantly in age, in sex-ratio, BMI, in smoker ratio and in troponin peak value. VF patients have a lower left ventricular ejection fraction (LVEF) (46.1% vs. 51.9%, P < 0.001). We observe a protective effect of polymorphism homozygous ADRB1-Gly49Gly (OR = 0.15, P = 0.03) and a slight tendency to risk sudden death for ADRB1-Arg389Arg (non significative). Analysis revealed a risk effect for polymorphism heterozygous ADRB2 Gln27Glu regarding a faster delay in the occurrence of FV ( P < 0,05). The ADRB2 Gln27Glu variant seems to predispose patients to fast onset VF in the setting of cardiac ischemia whereas the homozygous ADRB1Gly49Gly variant seems to protect patient to VF in the context of myocardial infarction.