European Heart Journal Advance Access published online on July 9, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn328
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The Ser96Ala variant in histidine-rich calcium-binding protein is associated with life-threatening ventricular arrhythmias in idiopathic dilated cardiomyopathy


1 Molecular Biology Division, Biomedical Research Foundation, Academy of Athens, Athens, Greece
2 Second Department of Cardiology, University of Athens, Attikon Hospital, Athens, Greece
3 Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA
4 Center for Molecular Cardiovascular Research, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
5 Second Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
6 Department of Pharmacology and Cell Biophysics, College of Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0575, USA
Received 20 December 2007; revised 13 June 2008; accepted 19 June 2008.
* Corresponding author. Tel: +1 513 558 2377, Fax: +1 513 558 2269, Email: litsa.kranias{at}uc.edu
Aims: To investigate whether genetic variants of the histidine-rich calcium (HRC)-binding protein are associated with idiopathic dilated cardiomyopathy (DCM) and its progression.
Methods and results: We screened 123 idiopathic DCM patients and 96 healthy individuals by single-strand conformation polymorphism analysis and direct sequencing for genetic variants in HRC. Six polymorphisms were detected: Leu35Leu (A/G), Ser43Asn (G/A), Ser96Ala (T/G), Glu202_Glu203insGlu (–/GAG), Asp261del (GAT/–), and an in-frame insertion of 51 amino acids at His321. The analysis of their frequencies did not reveal any significant correlation with DCM development. However, the Ser96Ala polymorphism exhibited a statistically significant correlation with the occurrence of life-threatening ventricular arrhythmias. During a follow-up of 4.02 ± 2.4 years, the risk for ventricular arrhythmias was higher (HR, 9.620; 95% CI, 2.183–42.394; P = 0.003) in the Ala/Ala patients, compared with Ser/Ser homozygous patients. On multivariable Cox regression analysis, the Ser96Ala polymorphism was the only significant genetic arrythmogenesis predictor in DCM patients (HR, 4.191; 95% CI, 0.838–20.967; P = 0.018).
Conclusion: The Ser96Ala genetic variant of HRC is associated with life-threatening ventricular arrhythmias in idiopathic DCM and may serve as an independent predictor of susceptibility to arrhythmogenesis in the setting of DCM.
Key Words: Calcium Sarcoplasmic reticulum Prognosis Defibrillation
D.S. and F.K. contributed equally to this work.
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