ACE基因rs4353多态性与房颤消融术后复发关系

The Association between Angiotensin Converting Enzyme Gene rs4353 Polymorphism and Atrial Fibrillation Recurrence after Catheter Ablation

目的探讨血管紧张素转换酶(angiotensin converting enzyme,ACE)基因多态性与房颤消融术后复发关系。方法随访2007年1月至2008年7月间在我院行单次房颤导管消融术的房颤患者,术后门诊定期常规心电图及24h动态心电图检查随访。选取ACE基因3个标签单核苷酸多态性(tagging single nucleotide polymorphisms,tSNPs)对房颤患者进行基因分型。结果成功随访150例行房颤消融术的患者(年龄:63.73±11.01岁,24.67%非阵发性房颤),其中复发61例(40.67%),中位随访期为57.50个月。rs4353基因型频率与等位基因频率在复发组与未复发组有统计学差异,其中T等位基因频率在复发组中明显低于未复发组(8.33%vs.19.10%,P=0.003)。CC、TC、TT三组基因型房颤患者复发率分别为54.10%(33/61),33.33%(22/66),22.73%(5/22)(Ptrend=0.003)。rs4353位点T等位基因的加性模型时,每增加一个拷贝的T等位基因,风险是增加前的0.473倍(95%CI:0.284-0.788,P=0.004,P校正=0.012)。进一步校正年龄、性别、体重指数、吸烟和饮酒因素后,T等位基因仍然显著降低房颤复发风险(OR=0.483,95%CI:0.282-0.837,P=0.009,P校正=0.027)。结论 ACE基因rs4353可能与房颤消融术后复发相关。

Objective To investigate the correlation between angiotensin converting enzyme（ACE） variants and atrial fibrillation（AF） recurrence after catheter ablation（CA）. Methods Acquired AF patients who received single catheter ablation procedure in our hospital from January 2007 to July 2008 underwent regular follow-up at our cardiology clinic. Standard electrocardiographs（ECGs） and 24-h Holter recordings were performed during follow-up to detect AF recurrence. Three tagging single nucleotide polymorphisms（tSNPs） in ACE gene were genotyped. Results A total of 150 AF patients（mean age 63.73±11.01 years, 24.67% non-paroxysmal AF） with symptomatic drug-refractory AF who underwent single CA procedure were enrolled. 61 patients suffered from AF recurrences after single CA procedure during a median follow-up period of 57.50 months. Of the three tSNPs, frequency of T allele of rs4353 was significantly lower in recurrence group（8.33%） than in non-recurrence group（19.10%）（P=0.003）. The recurrence rates of patients with CC, TC, and TT genotype were 54.10%（33/61）, 33.33%（22/66）, and 22.73%（5/22）, respectively（Ptrend=0.003）. T allele of rs4353 reduced the risk of AF recurrence post CA in additive model with odds ratio（OR） of 0.473（95%CI： 0.284-0.788, P=0.004, Padjust=0.012）. After adjusting for age, sex, body mass index（BMI）, drinking and smoking, the significance still remained with OR of 0.483（95%CI： 0.282-0.837, P=0.009, Padjust=0.027）. Conclusion ACE gene rs4353 polymorphism might be associated with AF recurrence after CA.