title: GNB3 C825T Polymorphism and Myocardial Recovery in Peripartum Cardiomyopathy: Results of the Multicenter Investigations of Pregnancy-Associated Cardiomyopathy Study.
abstract: BACKGROUND
  Black women are at greater risk for peripartum cardiomyopathy (PPCM). The guanine nucleotide-binding proteins β-3 subunit (GNB3) has a polymorphism C825T. The GNB3 TT genotype more prevalent in blacks is associated with poorer outcomes. We evaluated GNB3 genotype and myocardial recovery in PPCM.
  
  
  RESULTS
  A total of 97 women with PPCM were enrolled and genotyped for the GNB3 T/C polymorphism. Left ventricular ejection fraction (LVEF) was assessed by echocardiography at entry, 6 and 12 months postpartum. LVEF over time in subjects with the GNB3 TT genotype was compared with those with the C allele overall and in black and white subsets. The cohort was 30% black, age 30+6, LVEF 0.34+0.10 at entry 31+25 days postpartum. The % GNB3 genotype for TT/CT/CC=23/41/36 and differed markedly by race (blacks=52/38/10 versus whites=10/44/46, P<0.001). In subjects with the TT genotype, LVEF at entry was lower (TT=0.31+0.09; CT+CC=0.35+0.09, P=0.054) and this difference increased at 6 (TT=0.45+0.15; CT+CC=0.53+0.08, P=0.002) and 12 months (TT=0.45+0.15; CT+CC=0.56+0.07, P<0.001.). The difference in LVEF at 12 months by genotype was most pronounced in blacks (12 months LVEF for GNB3 TT=0.39+0.16; versus CT+CC=0.53+0.09, P=0.02) but evident in whites (TT=0.50++0.11; CT+CC=0.56+0.06, P=0.04).
  
  
  CONCLUSIONS
  The GNB3 TT genotype was associated with lower LVEF at 6 and 12 months in women with PPCM, and this was particularly evident in blacks. Racial differences in the prevalence and impact of GNB3 TT may contribute to poorer outcomes in black women with PPCM.
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.). richard.sheppard@mcgill.ca.
authors.forename: Richard
authors.initials: R
authors.lastname: Sheppard
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Eileen
authors.initials: E
authors.lastname: Hsich
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Julie
authors.initials: J
authors.lastname: Damp
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Uri
authors.initials: U
authors.lastname: Elkayam
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Angela
authors.initials: A
authors.lastname: Kealey
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Gautam
authors.initials: G
authors.lastname: Ramani
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Mark
authors.initials: M
authors.lastname: Zucker
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Alexis
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Horne
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Karen
authors.initials: K
authors.lastname: Hanley-Yanez
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Jessica
authors.initials: J
authors.lastname: Pisarcik
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Indrani
authors.initials: I
authors.lastname: Halder
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: James D
authors.initials: JD
authors.lastname: Fett
authors.affiliation: From the Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC, Canada (R.S.); Department of Cardiovascular Medicine, Cleveland Clinic Foundation, OH (E.H.); Department of Cardiology, Vanderbilt University, Nashville, TN (J.D.); Division of Cardiovascular Medicine, University of Southern California, Los Angeles (U.E.); Department of Medicine and Cardiovascular Sciences, University of Calgary, Calgary, AB, Canada (A.K.); Department of Cardiology, University of Maryland, Baltimore (G.R.); Cardiac Transplant Center, Beth Israel Newark Medical Center, NJ (M.Z.); Department of Cardiology, University of Rochester, NY (J.D.A.); Division of Cardiology, Intermountain Medical Center, Salt Lake City, Utah (B.D.H.); and Division of Cardiology, Heart, Lung, Blood, and Vascular Medicine Institute, University of Pittsburgh, PA (K.H.-Y., J.P., I.H., J.D.F., D.M.M.N.).
authors.forename: Dennis M
authors.initials: DM
authors.lastname: McNamara
mesh_terms: D000328:Adult; D001741:Black or African American / Q000235:genetics; D002170:Canada / Q000453:epidemiology; D009202:Cardiomyopathies / Q000175:diagnosis / Q000201:enzymology / Q000208:ethnology / Q000235:genetics* / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D005787:Gene Frequency; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease; D020962:Heterotrimeric GTP-Binding Proteins / Q000235:genetics*; D006801:Humans; D058725:Peripartum Period; D010641:Phenotype; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000201:enzymology / Q000208:ethnology / Q000235:genetics* / Q000503:physiopathology; D015995:Prevalence; D065840:Protective Factors; D020127:Recovery of Function; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left; D044465:White People / Q000235:genetics; D055815:Young Adult
chemical_list: C454420:G-protein beta3 subunit; D020962:Heterotrimeric GTP-Binding Proteins
keywords: cardiomyopathy; heart failure; peripartum period; polymorphism genetics; pregnancy