Adrenergic Polymorphisms and Survival in African Americans With Heart Failure: Results From A-HeFT

J Card Fail. 2019 Jul;25(7):553-560. doi: 10.1016/j.cardfail.2019.04.007. Epub 2019 Apr 9.

Abstract

Background: Polymorphisms in adrenergic signaling affect the molecular function of adrenergic receptors and related proteins. The β1 adrenergic receptor (ADRB1) Arg389Gly, G-protein receptor kinase type 5 (GRK5) Gln41Leu, G-protein β-3 subunit (GNB3) 825 C/T, and α2c deletion affect adrenergic tone, impact heart failure outcomes and differ in prevalence by ethnicity. Their combined effect within black cohorts remains unknown.

Methods and results: We analyzed subjects from the African American Heart Failure Trial (A-HeFT) by assessing event-free survival, quality of life, and gene coinheritance. Significant coinheritance effects on survival included GRK5 Leu41 among subjects co-inheriting GNB3 825 C alleles (n = 166, 90.4% vs 69.0%, P < 0.001). By contrast, the impact of ADRB1 Arg389Arg genotype was magnified among subjects with GNB3 825 TT genotype (n = 181, 66.3% vs 85.7%, P = .002). The lack of the α2c deletion (ie, insertion) led to a greater impact of the ARG389Arg genotype (n = 289, 76.4% vs 86.1%, P = .007).

Conclusions: Polymorphisms in adrenergic signaling affects outcomes in black subjects with heart failure. Coinheritance patterns in genetic variation may help determine heart failure survival.

Keywords: Heart failure; adrenergic receptor; adrenergic signaling; gene polymorphism.

MeSH terms

  • Black or African American / genetics*
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease
  • Heart Failure* / ethnology
  • Heart Failure* / genetics
  • Heart Failure* / mortality
  • Heart Failure* / physiopathology
  • Heterotrimeric GTP-Binding Proteins / genetics*
  • Humans
  • Male
  • Middle Aged
  • Polymorphism, Single Nucleotide
  • Prevalence
  • Progression-Free Survival
  • Receptors, Adrenergic, beta-1 / genetics*
  • Stroke Volume

Substances

  • ADRB1 protein, human
  • GNB3 protein, human
  • Receptors, Adrenergic, beta-1
  • Heterotrimeric GTP-Binding Proteins