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首页> 外文期刊>The American Journal of Cardiology >Impact of ??1- and ??2-adrenergic receptor gene single nucleotide polymorphisms on heart rate response to metoprolol prior to coronary computed tomographic angiography
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Impact of ??1- and ??2-adrenergic receptor gene single nucleotide polymorphisms on heart rate response to metoprolol prior to coronary computed tomographic angiography

机译：冠状动脉计算机断层血管造影术前?? 1-和?? 2-肾上腺素能受体基因单核苷酸多态性对美托洛尔心率反应的影响

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A slow, steady heart rate (HR) is necessary for optimal image quality during coronary computed tomographic angiography. Beta blockers are often used, but the goal HR is not achieved in some patients. The aim of this study was to examine the influence of single-nucleotide polymorphisms (SNPs) of the ??1 (codons 49 and 389) and ??2 (codons 16, 27, and 164) adrenergic receptor (AR) genes on HR response to metoprolol in 200 adults (mean age 56 ?? 11 years) referred for coronary computed tomographic angiography (using a 64-slice scanner). Oral and intravenous (IV) metoprolol was given to achieve a goal HR of 60 beats/min. Overall, 37 patients (18.5%) did not reach the goal HR despite the administration of oral (181 ?? 116 mg) and IV (4.2 ?? 9.4 mg) metoprolol. Patients with the ??1-AR Ser49Gly or Gly49Gly genotype (n = 49) more often failed to reach an optimal HR compared to those with the Ser49Ser genotype (n = 151) (29% vs 15%, p = 0.04), despite receiving higher doses of oral (210 ?? 115 vs 172 ?? 115 mg, p = 0.048) and IV (7 ?? 13 vs 3 ?? 8 mg, p = 0.02) metoprolol. Similarly, patients with the ??1-AR Gly389Gly genotype (n = 11) more often failed to reach an optimal HR compared to those with the Arg389Arg and Arg389Gly genotypes (n = 189) (45% vs 17%, p = 0.02), despite receiving higher doses of IV (13 ?? 15 vs 4 ?? 9 mg, p = 0.002) but not oral (162 ?? 105 vs 182 ?? 117 mg, p = 0.50) metoprolol. Multivariate analysis identified ??1-AR SNPs at codons 49 and 389 and ??2-AR SNP at codon 27 as independent predictors of suboptimal HR response. In conclusion, these data indicate that the selected SNPs of ??1-AR and ??2-AR genes influence HR response to metoprolol in patients who undergo coronary computed tomographic angiography. ? 2013 Elsevier Inc. All rights reserved.
机译：缓慢稳定的心率（HR）对于在冠状动脉计算机断层血管造影术中获得最佳图像质量是必要的。经常使用β受体阻滞剂，但某些患者无法达到目标HR。这项研究的目的是检查肾上腺素能受体（AR）基因?? 1（第49和389号密码子）和?? 2（第16、27和164号密码子）的单核苷酸多态性（SNP）对HR的影响200名成年人（平均年龄56 ?? 11岁）对美托洛尔的反应被转介给冠状动脉计算机断层血管造影（使用64层扫描仪）。给予口服和静脉（IV）美托洛尔以使目标HR≤60次/分钟。总体上，尽管口服美托洛尔（181 ?? 116 mg）和静脉注射美托洛尔（4.2 ?? 9.4 mg），仍有37例患者（18.5％）未达到目标HR。与具有Ser49Ser基因型（n = 151）的患者相比，具有?? 1-AR Ser49Gly或Gly49Gly基因型（n = 49）的患者更经常无法达到最佳HR（尽管分别为29％和15％，p = 0.04）接受更高剂量的口服美托洛尔（210 ?? 115 vs 172 ?? 115 mg，p = 0.048）和静脉注射（7 ?? 13 vs 3 ?? 8 mg，p = 0.02）。同样，与Arg389Arg和Arg389Gly基因型（n = 189）的患者相比，具有?? 1-AR Gly389Gly基因型（n = 11）的患者更经常无法达到最佳心率（45％vs 17％，p = 0.02）。尽管接受了更高剂量的美托洛尔静脉注射（13 ?? 15 vs 4 ?? 9 mg，p = 0.002），但未口服（162 ?? 105 vs 182 117 117 mg，p = 0.50）。多变量分析确定了第49和389位密码子的?? 1-AR SNP和第27位密码子的?? 2-AR SNP是次优HR反应的独立预测因子。总之，这些数据表明，在进行冠状动脉计算机断层血管造影术的患者中，β1-AR和β2-AR基因的选定SNP影响对美托洛尔的HR反应。 ？ 2013 Elsevier Inc.保留所有权利。

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