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. 2022 Oct 28;22(1):451.
doi: 10.1186/s12872-022-02901-5.

The effects of ALDH2 Glu487Lys polymorphism on vasovagal syncope patients undergoing head-up tilt test supplemented with sublingual nitroglycerin

G Xia #  1 , J F Jin #  1 , Y Ye  1 , X D Wang  1 , B Hu  1 , J L Pu  2
Affiliations

The effects of ALDH2 Glu487Lys polymorphism on vasovagal syncope patients undergoing head-up tilt test supplemented with sublingual nitroglycerin

G Xia et al. BMC Cardiovasc Disord. .

Abstract

Background and objective: Head-up tilt test (HUTT) is clinically advantageous for diagnosing patients with vasovagal syncope (VVS). Nitroglycerin is mainly used as a stimulant during HUTT, and mitochondrial aldehyde dehydrogenase 2 (ALDH2) is involved in the metabolism of nitroglycerin (NTG). ALDH2 Glu487Lys polymorphism (ALDH2 rs671) is the most common variant in the East Asian population. This study aimed to assess the effects of ALDH2 rs671 on VVS patients undergoing HUTT supplemented with sublingual NTG (HUTT-NTG). METHODS: Patients with recurrent VVS (at least 2 times) who were admitted to the syncope center of our hospital were enrolled. All VVS patients have undergone HUTT. The polymorphism of Glu487Lys gene of ALDH2 was measured by the DNA Microarray Chip Method. The results of HUTT-NTG of VVS patients with different ALDH2 genotypes were compared and their hemodynamic characteristics were assessed.

Results: A total of 199 VVS patients were enrolled, including 101 patients in the ALDH2*1/*1 group and 98 patients in the ALDH2*2 group. Among patients undergoing HUTT-NTG, 70.3% of patients in the ALDH2*1/*1 group and 68.4% of patients in the ALDH2*2 group were positive, and the difference between the two groups was not statistically significant (P = 0.77). The proportions of VASIS I, VASIS II, and VASIS III were 40.6%, 8.9%, and 20.8% in the ALDH2*1/*1 group, respectively, and the corresponding proportions in the ALDH2*2 group were 36.7%, 11.2%, and 20.4%, respectively. There was no statistically significant difference between the two groups (P = 0.91). The hemodynamic characteristics of different genotypes in VVS patients undergoing HUTT-NTG were compared, and no statistically significant difference was found. The median time of syncopal episode occurred after NTG administration in the ALDH2*1/*1 group was 6 min (interquartile range [IQR]: 5.0-9.0), and it was 6.0 min in the ALDH2*2 group (IQR: 4.25-8.0, P = 0.64).

Conclusion: ALDH2 Glu487Lys polymorphism did not affect the outcome of VVS patients undergoing HUTT-NTG, and no significant change in the hemodynamic characteristics of different genotypes was found.

Keywords: ALDH2 Glu487Lys polymorphism; Head-up tilt test; Nitroglycerin; Vasovagal syncope.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Hemodynamics and syncope time during HUTT-NTG in the ALDH2*1/*1 and ALDH2*2 groups. A HR changed during HUTT-NTG. B Changes in systolic blood pressure during HUTT-NTG. C Time box diagram of syncopal episodes during HUTT-NTG
Fig. 2
Fig. 2
A simple diagram of nitroglycerin metabolism
See this image and copyright information in PMC

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References

    1. Noormand R, Shafiee A, Davoodi G, Tavakoli F, Gheini A, Yaminisharif A, Jalali A, Sadeghian S. Age and the Head-Up Tilt Test Outcome in Syncope Patients. Res Cardiovasc Med. 2015;4(4):e27871. - PMC - PubMed
    1. Sutton R, Brignole M, Menozzi C, Raviele A, Alboni P, Giani P, Moya A. Dual-chamber pacing in the treatment of neurally mediated tilt-positive cardioinhibitory syncope : pacemaker versus no therapy: a multicenter randomized study The Vasovagal Syncope International Study (VASIS) Investigators. Circulation. 2000;102(3):294–299. doi: 10.1161/01.CIR.102.3.294. - DOI - PubMed
    1. Aksu T, Yalin K. Why is the Tilt Table Test Still Useful to Define who Should or Should Not Get A Pacemaker with Vasovagal Syncope? J Atr Fibrillation. 2021;13(5):2384. doi: 10.4022/jafib.2384. - DOI - PMC - PubMed
    1. Tan MP, Duncan GW, Parry SW. Head-up Tilt Table Testing: a state-of-the-art review. Minerva Med. 2009;100(4):329–338. - PubMed
    1. Natale A, Sra J, Akhtar M, Kusmirek L, Tomassoni G, Leonelli F, Newby K, Beheiry S, Pacifico A. Use of sublingual nitroglycerin during head-up tilt-table testing in patients >60 years of age. Am J Cardiol. 1998;82(10):1210–1213. doi: 10.1016/S0002-9149(98)00606-7. - DOI - PubMed

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