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Clinical Autonomic Research

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01-12-2009 | Research Article

Endothelin system polymorphisms in tilt test-induced vasovagal syncope

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

Published in: Clinical Autonomic Research | Issue 6/2009

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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Title: Endothelin system polymorphisms in tilt test-induced vasovagal syncope
Authors: Sandro Sorrentino
Cinzia Forleo
Massimo Iacoviello
Pietro Guida
Valentina D’Andria
Stefano Favale
Publication date: 01-12-2009
Publisher: D. Steinkopff-Verlag
Published in: Clinical Autonomic Research / Issue 6/2009
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-009-0008-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endothelin system polymorphisms in tilt test-induced vasovagal syncope

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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