A common polymorphism in KCNH2 (HERG) hastens cardiac repolarization

CR Bezzina, AO Verkerk, A Busjahn… - Cardiovascular …, 2003 - academic.oup.com
CR Bezzina, AO Verkerk, A Busjahn, A Jeron, J Erdmann, TT Koopmann, ZA Bhuiyan
Cardiovascular research, 2003academic.oup.com
Objective: Genetic variants of cardiac ion channels may influence cardiac repolarization.
Thereby such variants may modulate the penetrance of primary electrical disorders,
contribute to differences in susceptibility to drug-induced QT-prolongation between
individuals, or contribute to rhythm disturbances in the context of structural heart disease.
Since the current encoded by KCNH2 (HERG; I Kr) is a primary determinant of
repolarization, we conducted association studies between the respective alleles of the …
Abstract
Objective: Genetic variants of cardiac ion channels may influence cardiac repolarization. Thereby such variants may modulate the penetrance of primary electrical disorders, contribute to differences in susceptibility to drug-induced QT-prolongation between individuals, or contribute to rhythm disturbances in the context of structural heart disease. Since the current encoded by KCNH2 (HERG; IKr) is a primary determinant of repolarization, we conducted association studies between the respective alleles of the common amino acid-changing polymorphism at codon 897 (2690A>C; K897T) within HERG and rate-corrected QT interval (QTc). Methods and Results: Association analysis in Caucasian subjects (n = 1030) revealed a significant association of this polymorphism with QTc (P = 0.0025) with CC homozygotes having a significantly shorter QTc (388.5±2.9 ms) compared to AA homozygotes (398.5±0.9) and heterozygotes (AC, 397.2±1.2). The latter two genotypes were associated with comparable mean QTc's, suggesting that the 2690C-allele is recessive. After stratification by sex, the polymorphism was more predictive of QTc in females (P = 0.0021), a finding that was replicated in a second population sample (n = 352) from the same ethnic background (P = 0.044). To assess whether this polymorphism could represent a ‘functional’ polymorphism, we compared the biophysical properties of K897- and T897-HERG channels by whole-cell voltage clamp. Compared to the K897 channel, the T897 channel displayed a shift of −7 mV in voltage dependence of activation and increased rates of current activation and deactivation. Conclusion: As confirmed in modeling studies, these changes are expected to shorten action potential duration by an increase in IKr. This recapitulates the shorter QTc in females homozygous for the 2690C-allele.
Oxford University Press