The 212A variant of the APJ receptor gene for the endogenous inotrope apelin is associated with slower heart failure progression in idiopathic dilated cardiomyopathy.
BACKGROUND
Idiopathic dilated cardiomyopathy (IDC) has multiple genetic and acquired causes. Apelin is an endogenous peptide that increases cardiac inotropism through his APJ receptor. No data are available concerning the APJ gene mutations responsible for IDC or on the role of APJ receptor gene variants in predicting heart failure (HF) progression.


RESULTS
We prospectively evaluated 202 consecutive patients with IDC and 202 matched controls: 90 were screened for APJ gene mutations and all 202 were genotyped for G212A and A445C APJ receptor polymorphisms. No mutations were found within the coding or untranslated regions of the APJ receptor, and no differences in allelic or genotype frequencies were observed comparing patients with a healthy control population. The correlations between APJ receptor polymorphisms and HF progression were assessed. During a median follow-up of 37 months, 35 patients experienced HF progression. Univariate analysis showed that patients carrying at least 1 copy of 212A had a significantly lower risk for HF-related events than those who were homozygous for the G212 variant, and multivariate analysis confirmed that it was significantly related to a more favorable prognosis.


CONCLUSIONS
APJ is unlikely to be a gene causing IDC, but the independent correlation between the 212A allele and a better prognosis suggests that it might act as a modifier gene.
Sarzani
Riccardo
R
Department of Internal Medicine, University of Ancona-Politecnica delle Marche, Ancona, Italy.
Forleo
Cinzia
C
Pietrucci
Francesca
F
Capestro
Alessandro
A
Soura
Elli
E
Guida
Pietro
P
Sorrentino
Sandro
S
Iacoviello
Massimo
M
Romito
Roberta
R
Dessì-Fulgheri
Paolo
P
Pitzalis
Mariavittoria
M
Rappelli
Alessandro
A
D000225:Adenine; D000328:Adult; D000483:Alleles; D000073861:Apelin; D000075244:Apelin Receptors; D002311:Cardiomyopathy, Dilated / Q000235:genetics / Q000503:physiopathology*; D003596:Cytosine; D004252:DNA Mutational Analysis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D018628:Gene Dosage; D014644:Genetic Variation; D005838:Genotype; D006147:Guanine; D006239:Haplotypes; D006720:Homozygote; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D015810:Linkage Disequilibrium; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011110:Polymorphism, Genetic; D011379:Prognosis; D011446:Prospective Studies; D043562:Receptors, G-Protein-Coupled / Q000235:genetics*