Korean J Anesthesiol.  2011 Aug;61(2):117-121. 10.4097/kjae.2011.61.2.117.

The effect of beta1-adrenergic receptor gene polymorphism on prolongation of corrected QT interval during endotracheal intubation under sevoflurane anesthesia

• Park K
• Jang SB
• Kweon TD
• Kim JH
• Han DW

• KMID: 1766704
• DOI: http://doi.org/10.4097/kjae.2011.61.2.117

Abstract

BACKGROUND
The hemodynamic responses to endotracheal intubation are associated with sympathoadrenal activity. Polymorphisms in the beta1-adrenergic receptor (beta1AR) gene can alter the pathophysiology of specific diseases. The aim of this study is to investigate whether the Ser49Gly and Arg389Gly polymorphism of the beta1AR gene have different cardiovascular responses during endotracheal intubation under sevoflurane anesthesia.
METHODS
Ninety-one healthy patients undergoing general anesthesia were enrolled. Patients underwent slow inhalation induction of anesthesia using sevoflurane in 100% oxygen. Vecuronium 0.15 mg/kg was given for muscle relaxation. Endotracheal intubation was performed by an anesthesiologist. The mean arterial pressure (MAP), heart rate (HR), and the corrected QT (QTc) interval were measured before induction, before laryngoscopy, and immediately after tracheal intubation. Genomic DNA was isolated from the patients' peripheral blood and then evaluated for the beta1AR-49 and beta1AR-389 genes using an allele-specific polymerase chain reaction method.
RESULTS
No differences were found in the baseline values of MAP, HR, and the QTc interval among beta1AR-49 and beta1AR-389, respectively. In the case of beta1AR-49, the QTc interval change immediately after tracheal intubation was significantly greater in Ser/Ser genotypes than in Ser/Gly genotypes. No differences were observed immediately after tracheal intubation in MAP and HR for beta1AR-49 and beta1AR-389.
CONCLUSIONS
We found an association between the Ser49 homozygote gene of beta1AR-49 polymorphism and increased QTc prolongation during endotracheal intubation with sevoflurane anesthesia. Thus, beta1AR-49 polymorphism may be useful in predicting the risk of arrhythmia during endotracheal intubation in patients with long QT syndrome.

Keyword

Beta1 adrenergic receptor; Endotracheal intubation; Polymorphism

MeSH Terms

Anesthesia
Anesthesia, General
Arrhythmias, Cardiac
Arterial Pressure
DNA
Genotype
Heart Rate
Hemodynamics
Homozygote
Humans
Inhalation
Intubation
Intubation, Intratracheal
Laryngoscopy
Long QT Syndrome
Methyl Ethers
Muscle Relaxation
Oxygen
Polymerase Chain Reaction
Vecuronium Bromide
DNA
Methyl Ethers
Oxygen
Vecuronium Bromide