Can apical ballooning cardiomyopathy and anterior STEMI be differentiated based on β1 and β2-adrenergic receptors polymorphisms?

Int J Cardiol. 2015 Nov 15:199:189-92. doi: 10.1016/j.ijcard.2015.07.054. Epub 2015 Jul 17.

Abstract

Aim: Catecholamine excess along with an exaggerated sympathetic stimulation appears to play a major role in the pathophysiological mechanism of tako-tsubo cardiomyopathy (TTC), which mimics acute ST-elevation myocardial infarction (STEMI). The aim of the present study was to investigate differences in the distribution of allelic variants of β1- and β2-adrenoceptors between TTC and anterior STEMI patients compared to normal subjects.

Methods and results: β1- and/or β2-adrenoceptor polymorphisms in 97 patients with TTC (92 females, 96%; mean age 66.8±11.6years; range 35 to 87years) were compared with 81 patients with anterior STEMI (77 females, 95%; mean age 72.5±12.8years; range 32 to 96years) and 101 controls (95 females, 94%; mean age 62.3±10.4years; range 44 to 92years). Differences in genotype frequencies were assessed using the Pearson χ(2) test. β1-Adrenoceptor (Gly389Arg) and β2-adrenoceptor (Arg16Gly and Gln27Glu) genotype frequencies were significantly different among groups (p<0.001, p=0.024, p=0.008, respectively). However, differences did not achieve statistical significance when TTC and anterior STEMI patients were compared by post-hoc analysis. The cardiovascular risk factor profile was worse in anterior STEMI patients, who more often had a history of systemic arterial hypertension, diabetes and coronary artery disease.

Conclusions: In a large TTC cohort compared with anterior STEMI patients, β-adrenoceptor polymorphisms were similar. However, the cardiovascular risk factor profile was different between the two groups. β-Adrenoceptor polymorphisms in TTC patients differed from normal subjects.

Keywords: ST-elevation myocardial infarction; Tako-tsubo cardiomyopathy; β-Adrenoceptor polymorphisms.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiomyopathies / genetics*
  • Cardiomyopathies / pathology
  • Cardiovascular Diseases / genetics*
  • Cardiovascular Diseases / pathology
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / etiology
  • Diagnosis, Differential
  • Female
  • Genotype
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / genetics*
  • Myocardial Infarction / pathology
  • Polymorphism, Single Nucleotide / genetics*
  • Receptors, Adrenergic, beta-1 / genetics*
  • Receptors, Adrenergic, beta-2 / genetics*
  • Risk Factors
  • Takotsubo Cardiomyopathy / genetics*
  • Takotsubo Cardiomyopathy / pathology
  • Takotsubo Cardiomyopathy / physiopathology
  • White People / genetics

Substances

  • Receptors, Adrenergic, beta-1
  • Receptors, Adrenergic, beta-2