Neurovascular control during exercise in acute coronary syndrome patients with Gln27Glu polymorphism of beta(2)-adrenergic receptor

作者：Ferreira Santos Larissa; Martinez Daniel G; Nicolau Jose Carlos; Moreira Humberto G; Alves Maria Janieire; Pereira Alexandre C; Trombetta Ivani C; Negrao Carlos Eduardo; Rondon Maria Urbana P B^*

来源：PLos One, 2017, 12(2): e0173061.

DOI：10.1371/journal.pone.0173061

Background
Gln27Glu ( rs1042714) polymorphism of the beta(2)-adrenergic receptor ADRB2) has been association with cardiovascular functionality in healthy subjects. However, it is unknown whether the presence of the ADRB2 Gln27Glu polymorphism influences neurovascular responses during exercise in patients with acute coronary syndromes ACS). We tested the hypothesis that patients with ACS homozygous for the Gln allele would have increased muscle sympathetic nerve activity MSNA) responses and decreased forearm vascular conductance FVC) responses during exercise compared with patients carrying the Glu allele Gln27Glu and Glu27Glu). In addition, exercise training would restore these responses in Gln27Gln patients.
Methods and results
Thirty-days after an ischemic event, 61 patients with ACS without ventricular dysfunction were divided into 2 groups: 1) Gln27Gln n = 35, 53 +/- 1years) and 2) Gln27Glu+Glu27Glu n = 26, 52 +/- 2years). MSNA was directly measured using the microneurography technique, blood pressure BP) was measured with an automatic oscillometric device, and blood flow was measured using venous occlusion plethysmography. MSNA, mean BP, and FVC were evaluated at rest and during a 3-min handgrip exercise. The MSNA P = 0.02) and mean BP P = 0.04) responses during exercise were higher in the Gln27Gln patients compared with that in the Gln27Glu+Glu27Glu patients. No differences were found in FVC. Two months of exercise training significantly decreased the MSNA levels at baseline P = 0.001) and in their response during exercise P = 0.02) in Gln27Gln patients, but caused no changes in Gln27Glu+Glu27Glu patients. Exercise training increased FVC responses in Gln27Glu +Glu27Glu patients P = 0.03), but not in Gln27Gln patients.
Conclusion
The exaggerated MSNA and mean BP responses during exercise suggest an increased cardiovascular risk in patients with ACS and Gln27Gln polymorphism. Exercise training emerges as an important strategy for restoring this reflex control. Gln27Glu polymorphism of ADRB2 influences exercise-induced vascular adaptation in patients with ACS.

• 出版日期2017-2-24