The association between heme oxygenase-1 gene promoter polymorphism and the outcomes of catheter ablation of atrial fibrillation

PLoS One. 2013;8(2):e56440. doi: 10.1371/journal.pone.0056440. Epub 2013 Feb 20.

Abstract

A length polymorphism of GT repeats in the promoter region of the human heme oxygenase-1 (HO-1) gene modulates its gene transcription to protect against myocardial injury. The present study investigated the association between HO-1 promoter polymorphisms and the outcomes of catheter ablation of atrial fibrillation (AF). The allelic frequencies of GT repeats in the HO-1 gene promoter were screened in 205 random individuals who underwent catheter ablation for drug refractory AF.In the patients who received catheter ablation, those with AF recurrence had fewer GT repeats (53.4±7.1 vs. 56.1±6.5, p = 0.004), a lower incidence of hyperlipidemia, more non-paroxysmal AF, and a larger left atrial diameter. After conducting a multivariate logistic analysis, the number of GT repeats (Odds ratio: 0.94, 95% CI 0.90-0.99, p = 0.01) and the diameter of the left atrium (Odds ratio: 1.08, 95% CI 1.02-1.15, p = 0.01) remained independent predictors. The carriers of GT repeats, which were <29 in both alleles, were associated with a lower sinus maintenance rate after catheter ablation (38.5% vs. 60.1%, p = 0.003). The patients were divided into paroxysmal and non-paroxysmal AF groups; the number of GT repeats was associated with AF recurrence only in the patients with paroxysmal AF. The number of GT repeats, combined with LAD, was significant for predicting AF recurrence after catheter ablation (p = 0.01). The number of GT repeats was not found to be associated with differences in the left atrial diameter, the biatrial voltage, or the levels of bilirubin, ferritin, iron, C-reactive protein, or von-Willibrand factor. In conclusions, HO-1 gene promoter polymorphisms were associated with AF recurrence after catheter ablation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atrial Fibrillation / genetics*
  • Atrial Fibrillation / pathology
  • Atrial Fibrillation / therapy*
  • C-Reactive Protein / genetics
  • C-Reactive Protein / metabolism
  • Catheter Ablation / methods*
  • Female
  • Follow-Up Studies
  • Genetic Association Studies
  • Heme Oxygenase-1 / genetics*
  • Humans
  • Male
  • Microsatellite Repeats / genetics
  • Prognosis
  • Promoter Regions, Genetic
  • Recurrence
  • Treatment Outcome
  • von Willebrand Factor / genetics
  • von Willebrand Factor / metabolism

Substances

  • von Willebrand Factor
  • C-Reactive Protein
  • Heme Oxygenase-1

Grants and funding

This work was supported by research grants from the Taipei Veterans General Hospital (V98C1-037, V99C1-120, V101B-005, V101C-060) and the National Scientific Council (NSC97-2314-B-010-037-MY3, NSC97-2314-B-010-038, NSC98-2314-B-010-031-MY3, NSC 99-2911-I-008-100, NSC 100-2314-B-075-051, NSC 101-2321-B-075-004). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.