BACKGROUND:

It was recently suggested that the angiotensin-converting enzyme insertion/insertion genotype, which is considered to be protective against cardiovascular disease, was a significant risk factor for atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). The aim of this study was to investigate the association between the endothelin-2 (EDN2) A985G polymorphism and AF in patients with HCM.

METHODS AND RESULTS:

The EDN2 A985G polymorphism (rs 5800) was genotyped in 110 patients with HCM who had no clinically documented AF before medical treatment. The distribution of the EDN2 genotypes (G/G, G/A, and A/A) was 77.3%, 19.1%, and 3.6%, respectively. The EDN2 A allele frequency was 0.21 in 26 patients who subsequently developed AF during long-term follow-up and 0.11 in 84 patients who remained in sinus rhythm. The distribution of genotypes of the dominant EDN2 A allele between the two groups was significantly different by chi-square analysis (42.3% vs 16.7%, p=0.014). In a multivariate model, the A985 allele of the EDN2 gene was associated with increased adjusted risk for the occurrence of AF (p=0.018).

CONCLUSION:

The EDN2 A985 allele, which is considered to be protective in cardiovascular disease, may be a risk factor for AF in patients with HCM.