Abstract
BackgroundVentricular fibrillation (VF) in the setting of acute ST elevation myocardial infarction (STEMI) is a leading cause of mortality. Although the risk of VF has a genetic component, the underlying genetic factors are largely unknown. Since heart rate and ECG intervals of conduction and repolarization during acute STEMI differ between patients who do and patients who do not develop VF, we investigated whether SNPs known to modulate these ECG indices in the general population also impact on the respective ECG indices during STEMI and on the risk of VF.Methods and ResultsThe study population consisted of participants of the Arrhythmia Genetics in the NEtherlandS (AGNES) study, which enrols patients with a first STEMI that develop VF (cases) and patients that do not develop VF (controls). SNPs known to impact on RR interval, PR interval, QRS duration or QTc interval in the general population were tested for effects on the respective STEMI ECG indices (stage 1). Only those showing a (suggestive) significant association were tested for association with VF (stage 2). On average, VF cases had a shorter RR and a longer QTc interval compared to non-VF controls. Eight SNPs showed a trend for association with the respective STEMI ECG indices. Of these, three were also suggestively associated with VF.ConclusionsRR interval and ECG indices of conduction and repolarization during acute STEMI differ between patients who develop VF and patients who do not. Although the effects of the SNPs on ECG indices during an acute STEMI seem to be similar in magnitude and direction as those found in the general population, the effects, at least in isolation, are too small to explain the differences in ECGs between cases and controls and to determine risk of VF.
Highlights
Sudden cardiac death (SCD) is a leading cause of death in adults in the Western world [1]
RR interval and ECG indices of conduction and repolarization during acute ST elevation myocardial infarction (STEMI) differ between patients who develop Ventricular fibrillation (VF) and patients who do not
The effects of the single nucleotide polymorphisms (SNPs) on ECG indices during an acute STEMI seem to be similar in magnitude and direction as those found in the general population, the effects, at least in isolation, are too small to explain the differences in ECGs between cases and controls and to determine risk of VF
Summary
Sudden cardiac death (SCD) is a leading cause of death in adults in the Western world [1]. While the risk of VF is known to have a genetic component, the underlying genetic factors are yet largely unknown [3,4,5]. Electrocardiographic indices of conduction and repolarization are considered important quantifiable intermediate phenotypes for arrhythmia risk [6]. In support of this concept, ECG indices measured during the acute phase of ST elevation MI (STEMI). Since heart rate and ECG intervals of conduction and repolarization during acute STEMI differ between patients who do and patients who do not develop VF, we investigated whether SNPs known to modulate these ECG indices in the general population impact on the respective ECG indices during STEMI and on the risk of VF
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