• Adem Atici, Mehmet Rasih-Sonsoz, Hasan Ali-Barman, Eser Durmaz, Ahmet Demirkiran, Kamil Gulsen, Ali Elitok, Imran Onur, Irfan Sahin, and Kaya BilgeAhmetACardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul..
• Cardiology Department of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
• Rev Invest Clin. 2020 May 7; 72 (5).

BackgroundVasovagal syncope (VVS) is a common clinical condition involving genetic background. The role of beta-blockers in the treatment is controversial.ObjectiveThe aim of this study was to investigate the effect of beta-1 gene polymorphism on beta-blocker therapy in patients with VVS.MethodsWe included 123 patients who were diagnosed with VVS after the tilttable test. We searched for the polymorphism Arg389Gly (rs1801253) in the beta-1 adrenoceptor gene.ResultsOverall, 64 patients (52%) had Arg389Arg with Arg389Arg genotype were more frequent compared with patients having Arg389Gly genotype (total syncopal episodes [TSE], 7.9 ± 3.7 vs. 6.4 ± 3.0; p = 0.012). TSE in patients with Arg389Arg genotype decreased significantly after 18 months of beta-blocker treatment (7.9 ± 3.7 vs. 3.0 ± 1.4, p < 0.001). After 18 months of beta-blocker treatment, patients with Arg389Arg genotype had significantly fewer syncopal episodes than patients with Arg389Gly genotype (3.0 ± 1.4 vs. 6.8 ± 3.2, p < 0.001).ConclusionsResults of beta-blocker therapy in patients with Arg389Arg genotype suggest that VVS pathophysiology is a multifactorial condition, with genetic, psychological, and environmental components, and therefore, treatment selection can be based on gene polymorphism.

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