Pharmacogenetics of β1-Adrenergic Receptor Blockers in Heart Failure Therapy: A Systematic Review
- Corresponding Author:
- Beyene Tufa
Department of Biomedical Science
College of Veterinary Medicine and Agriculture
Addis Ababa University
Bishoftu/ Debre Zeit, Ethiopia
E-mail: [email protected]
Received September 06, 2013; Accepted October 23, 2013; Published October 29, 2013
Citation: Tufa TB, Petros Z, Melke LF (2013) Pharmacogenetics of ß1-Adrenergic Receptor Blockers in Heart Failure Therapy: A Systematic Review Cardiol Pharmacol 2:113. doi: 10.4172/2329-6607.1000113
Copyright: © 2013 Tufa TB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: β1-adrenergic receptor blockers are an important drugs recommended as first-line treatment of Heart Failure (HF) as they improve survival in left ventricular systolic dysfunction due to chronic β1-Adrenergic Receptor (β1-AR) activation. However, responses to these drugs are variable among patients due to genetic polymorphism in β1-AR gene. We conducted a systematic review to summarize all published case-control and prospective studies on pharmacogenetics of β1-adrenergic receptor blockers (β1-ARBs) used for the management of HF.
Methods and findings: We performed a systematic search of the literature using Medline (source PubMed, January 1, 1980 to November 30, 2011) with restrictions for English language and polymerase chain reaction assay method of genotyping the receptor polymorphism. Both experimental and observational studies investigating the pharmacogenetics effect of β1-adrenergic receptor blockers in heart failure were included. The main outcome measure was improvement of HF symptoms which is reflected in a decrease in mortality, hospitalisation and the rate of major clinical events. Of the 30 included studies, 17 articles reporting on effect of genetic polymorphisms of β1-AR on heart failure, 11 articles reporting on pharmacogenetics of β1-ARBs in HF, and 2 articles reporting on both β1-AR gene polymorphisms and pharmacogenetics of β1-ARBs, were included into the results.
Conclusions: The findings of the current study have shown that β1-AR polymorphisms have an effect on survival and improvement in left ventricular ejection fraction in HF patients who were Arg389 homozygotes carriers treated with metoprolol and bucindolol. Therefore, the Arg389 of β1-AR variation alters the β1-ARBs therapeutic response, and might be used to individualize treatment of HF.