Phenotypic and molecular genetic predictors of Wolff-Parkinson-White syndrome

Aim. To study the phenotypic and molecular genetic characteristics of patients with Wolff-Parkinson-White (WPW) syndrome.

Material and methods. The study group consisted of 200 patients with WPW syndrome, including 97 men (n=48,5%) and 103 women (n=51,5%). All patients underwent clinical and paraclinical examinations, including electrocardiography (ECG), Holter monitoring, echocardiography, somatometry according to the standard V. V. Bunak method, and molecular genetic testing. DNA was extracted using the phenol-chloroform method, and genotyping was performed using the polymerase chain reaction.

Results. Multivariate regression analysis revealed significant associations between some factors and WPW syndrome. The strongest predictor was a delta wave on the ECG (odds ratio (OR) =21,3; p<0,0001). Genetic variants PRKAG3="CC" (OR =16,7; p=0,0009), PRKAG2="GA" (OR =6,3; p=0,0023) and TBX3="GG" (OR =6,1; p=0,0078) also demonstrated a significant association with an increased probability of WPW syndrome. An increase in the QRS duration (OR =1,1 per unit; p<0,0001) and heart rate (OR =1,1; p=0,0008) on the ECG were associated with a non-significant odds increase. In contrast, QT interval increase (OR =0,97; p<0,0001) and higher height (OR =0,96; p=0,0073) were associated with a low risk of WPW syndrome. Rees-Eysenck normosthenic body type significantly reduced the odds (OR =0,47; p=0,0367).

Conclusion. Heredity is a key factor in the development of WPW syndrome, as confirmed by data from numerous studies. Phenotypic characteristics, in addition to genetic markers, can serve as a valuable tool for risk stratification and the development of preventive strategies aimed at preventing the manifestation of WPW syndrome.

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