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Endothelin system polymorphisms in tilt test-induced vasovagal syncope

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Abstract

Introduction

Genetics may be involved in the pathophysiology of vasovagal syncope. The 3A/4A polymorphism of the EDN1 gene affects the expression of endothelin-1, and the H323H T/C polymorphism of the EDNRA gene encoding for the endothelin type A receptor has been associated with cardiovascular pathologies. As the endothelin system participates in the regulation of cardiovascular homeostasis, the aim of this study was to analyse the role of these genetic variants in influencing tilt-induced vasovagal syncope.

Materials and methods

We recorded the cardiovascular parameters of 107 otherwise healthy subjects with recurrent unexplained syncope who underwent a head-up tilt test; 58 (54%) fainted.

Results

In terms of the EDNRA polymorphism, eight subjects (8%) had the T/T genotype, 41 were heterozygous (38%) and 58 homozygous (54%) for the C allele. Sixty subjects (56%) carried homozygosis for the 3A allele of the EDN1 polymorphism and 47 were heterozygous (44%). The 4A allele was significantly more frequent in the patients who responded positively to the tilt test than in those who did not: the relative odds ratios and confidence intervals at univariate and multivariate analyses were respectively 2.37 (1.07–5.26) and 2.41 (1.05–5.49). Comparisons with a control group further supported these data. Among the tilt-positive patients, the carriers of the 4A allele were more likely to have a vasodepressive pattern than those who were homozygous for the 3A variant.

Conclusion

In conclusion, the 3A/4A polymorphism of the EDN1 gene affects susceptibility to syncope, and the 4A variant associated with increased endothhelin-1 expression may promote vasodepressive hemodynamic responses during tilt testing.

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Acknowledgments

The authors would like to thank Dr. Luciana D’Alonzo, Mr. Cataldo Balducci, Mrs. Margherita Sarlo and Mrs. Mariella Vitone for their helpful cooperation. This study was partially supported by grants from the University of Bari.

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Authors and Affiliations

  1. Cardiology Unit, Emergency and Organ Transplantation Department, University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy

    Sandro Sorrentino, Cinzia Forleo, Massimo Iacoviello, Pietro Guida, Valentina D’Andria & Stefano Favale

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  1. Sandro Sorrentino
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  2. Cinzia Forleo
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  3. Massimo Iacoviello
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  4. Pietro Guida
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  5. Valentina D’Andria
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  6. Stefano Favale
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Corresponding author

Correspondence to Cinzia Forleo.

Additional information

S. Sorrentino and C. Forleo contributed equally to this paper.

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Sorrentino, S., Forleo, C., Iacoviello, M. et al. Endothelin system polymorphisms in tilt test-induced vasovagal syncope. Clin Auton Res 19, 347–354 (2009). https://doi.org/10.1007/s10286-009-0008-3

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  • DOI: https://doi.org/10.1007/s10286-009-0008-3

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