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Cardiology
Article . 2007 . Peer-reviewed
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Cardiology
Article . 2008
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Association of Met439Thr Substitution in Heat Shock Protein 70 Gene with Postoperative Atrial Fibrillation and Serum HSP70 Protein Levels

Authors: Afzal, AR; Mandal, K; Nyamweya, S; Foteinos, G; Poloniecki, J; Camm, AJ; Jahangiri, M; +1 Authors

Association of Met439Thr Substitution in Heat Shock Protein 70 Gene with Postoperative Atrial Fibrillation and Serum HSP70 Protein Levels

Abstract

<i>Background:</i> Atrial fibrillation (AF) is a common arrhythmia encountered following cardiac surgery. Previously, we have shown that higher expression of heat shock protein (HSP) 70 was associated with decreased incidence of postoperative AF (PoAF), suggestive of an antiarrhythmic role. <i>Objective:</i> We have hypothesised that Met493Thr substitution of one of the important <i>hsp</i>70 genes may cause loss of these protective antiarrhythmic effects. We therefore set out to examine the influence of <i>hsp</i>70 genotype on the incidence of PoAF. <i>Methods and Results:</i> We prospectively recruited 244 Caucasian patients undergoing elective coronary artery bypass surgery. The median age was 65 years (40–80 years). PoAF was defined as the characteristic arrhythmia lasting for at least 15 min, occurring within first week following surgery and requiring treatment. This occurred in 48 patients (19.7%). Validated Met493Thr substitution in<i> hsp</i>70-Hom was determined using established techniques. Of 244 patients, genotype was determined for 242 cases. The three genotypes (MM, MT, and TT) were present at frequencies of 0.66, 0.31, and 0.03, respectively, and were in Hardy-Weinberg equilibrium. In unifactorial analysis patients carrier or homozygous for 493Thr mutation had significantly higher incidence of PoAF (Pearson χ<sup>2</sup> = 4.3, p = 0.037). Multivariate analysis confirmed the positive association of <i>hsp</i>70-Hom with PoAF (OR, 2.43; p = 0.016) independent of age, sex, previous myocardial infarction, number of distal anastomoses, and duration of ventilation, respectively. Serum HSP70 was ranging from 0.74 to 31.91 ng/ml (median, 2.89) and was not correlated with PoAF. Presence of 493Thr mutation was also significantly correlated with higher levels of serum HSP70 (p <i>= </i>0.009). <i>Conclusions:</i> Our data show that a mutation in <i>hsp</i>70-Hom gene is associated with higher incidence of PoAF. These findings are consistent with our previous results and may suggest that patients harbouring this substitution will have less endogenous myocardial protection against AF in stressful situations.

Keywords

Adult, Aged, 80 and over, Genetic Markers, Male, Genotype, Incidence, 610, Coronary Disease, Electrocardiography, Logistic Models, Amino Acid Substitution, Elective Surgical Procedures, Case-Control Studies, Atrial Fibrillation, Humans, Female, HSP70 Heat-Shock Proteins, Coronary Artery Bypass, HSP110 Heat-Shock Proteins, Aged, Follow-Up Studies

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    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
38
Top 10%
Top 10%
Top 10%
gold