ISSN: 0034-8376
eISSN: 2564-8896
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Abstract

The role of Beta-1 Receptor gene polymorphism in Beta-Blocker therapy for vasovagal syncope

VOLUME - NUMBER / (Forthcoming Articles)

Adem Atici, Cardiology Department of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
Mehmet Rasih-Sonsoz, Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
Hasan Ali-Barman, Cardiology Department of Okmeydani Training and Research Hospital, Istanbul, Turkey
Eser Durmaz, Cardiology Department of Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
Ahmet Demirkiran, Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
Kamil Gulsen, Bagcilar Training and Research Hospital, Istanbul, Turkey
Ali Elitok, Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
Imran Onur, Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
Irfan Sahin, Bagcilar Training and Research Hospital, Istanbul, Turkey
Ahmet Kaya Bilge, Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul, Turkey

Background: Vasovagal syncope (VVS) is a common clinical condition involving genetic background. The role of beta-blockers in the treatment is controversial. Objective: The aim of this study was to investigate the effect of beta-1 gene polymorphism on beta-blocker therapy in patients with VVS. Methods: We included 123 patients who were diagnosed with VVS after the tilttable test. We searched for the polymorphism Arg389Gly (rs1801253) in the beta-1 adrenoceptor gene. Results: Overall, 64 patients (52%) had Arg389Arg genotype and 59 patients (48%) had Arg389Gly genotype. The syncopal episodes of patients with Arg389Arg genotype were more frequent compared with patients having Arg389Gly genotype (total syncopal episodes [TSE], 7.9 ± 3.7 vs. 6.4 ± 3.0; p = 0.012). TSE in patients with Arg389Arg genotype decreased significantly after 18 months of beta-blocker treatment (7.9 ± 3.7 vs. 3.0 ± 1.4, p < 0.001). After 18 months of beta-blocker treatment, patients with Arg389Arg genotype had significantly fewer syncopal episodes than patients with Arg389Gly genotype (3.0 ± 1.4 vs. 6.8 ± 3.2, p < 0.001). Conclusions: Results of beta-blocker therapy in patients with Arg389Arg genotype suggest that VVS pathophysiology is a multifactorial condition, with genetic, psychological, and environmental components, and therefore, treatment selection can be based on gene polymorphism.

Keywords: Genetic polymorphism. Vasovagal syncope. Beta-blocker treatment.

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