title: Allelic variant of NOS1AP effects on cardiac alternans of repolarization during exercise testing.
abstract: BACKGROUND
  A repolarization abnormality manifested as T-wave alternans (TWA) in electrocardiogram (ECG) predicts cardiovascular mortality. A common variant in the NOS1AP gene is associated with mortality and QT interval duration, possibly in a gender-specific manner, but data is lacking on potential association with TWA. This study tested association between rs10494366 in NOS1AP and both TWA and 4-year mortality.
  
  
  METHODS
  A total of 1963 Finnish Cardiovascular Study participants (36.6% female, 57.1 ± 13.0 years) were genotyped and their maximal TWA values were measured from continuous ECG recordings during clinical exercise test at rest, exercise and recovery.
  
  
  RESULTS
  We observed a significant gender-specific effect of NOS1AP genotype on TWA. In all subjects, there was no statistically significant difference between the three genotypes (TT, TG, GG) in the responses of TWA over the entire exercise test (time-by-genotype interaction p = 0.057). In women, after adjustment for age, coronary heart disease and β-blocker medication status, changes of TWA over different phases of exercise test were significantly associated with NOS1AP genotype (time-by-genotype interaction p = 0.001). In men, NOS1AP rs10494366 was not associated with TWA. During follow-up (mean 47 months), 113 patients died. NOS1AP rs10494366 was not a statistically significant predictor of mortality.
  
  
  CONCLUSIONS
  The NOSIAP variant rs10494366 influences TWA and TWA response during clinical exercise test in females. Gender-specific effects have also been previously reported for the influence of the variant on QT interval. If replicated, these findings should prompt studies to further elucidate the mechanisms underlying the gender differences in NOS1AP effects on repolarization.
authors: Department of Internal Medicine, Tampere University Hospital and School of Medicine at the University of Tampere, Finland. jenni.k.koskela@uta.fi
authors: Jenni
authors: J
authors: Koskela
authors: Mika
authors: M
authors: Kähönen
authors: Tuomo
authors: T
authors: Nieminen
authors: Rami
authors: R
authors: Lehtinen
authors: Jari
authors: J
authors: Viik
authors: Kjell
authors: K
authors: Nikus
authors: Kari
authors: K
authors: Niemelä
authors: Tiit
authors: T
authors: Kööbi
authors: Martin D
authors: MD
authors: Tobin
authors: Nilesh J
authors: NJ
authors: Samani
authors: Väinö
authors: V
authors: Turjanmaa
authors: Ilkka
authors: I
authors: Pörsti
authors: Terho
authors: T
authors: Lehtimäki
mesh_terms: D048868:Adaptor Proteins, Signal Transducing / Q000235:genetics*; D000328:Adult; D000368:Aged; D000483:Alleles; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D048868:Adaptor Proteins, Signal Transducing; C488081:NOS1AP protein, human