Genetic aspects of vasovagal syncope: a systematic review of current evidence

Abstract

Knowledge on the aetiology of vasovagal syncope (VVS) is of great importance to optimize its diagnostic and therapeutic options. To unravel the largely unknown pathophysiology, studies on genetic aspects of VVS can be of use. This systematic review on all available literature aims to provide an overview of the current knowledge of VVS genetics. The MEDLINE and EMBASE database were systematically searched for all studies discussing genetic factors as a cause of VVS. Hereditary aspects of VVS were studied in 19 studies. Six studies determined a positive family history in, respectively, 19-90% of the VVS patients. These numbers, however, are not higher than the cumulative incidence of VVS in the general population (35-39%). Four studies examined potential genetic polymorphisms associated with VVS. Only a Gly389 allele was more frequently present in VVS patients with a positive HUT test, although the significance level was set much higher than usual in genetic studies, and this result has not been replicated so far. Knowledge on genetic aspects of VVS could be very useful in clinical practice and research, but the current evidence that it has a genetic basis is not very strong.

Arg389Gly β1-adrenergic receptor polymorphism and susceptibility to syncope during tilt test

“…Still, the association of various genetic variations with VVS is not as evident as initially expected, due to the limited number of relevant research papers focused on the matter [11] and further overshadowed by small sample sizes. In a study of French patients with unexplained syncope, a strong association between syncopal incidence, positive HUT and CC variant in the adenosine A 2A receptor ( ADORA 2A ) gene was found [12].…”

Autosomal dominant vasovagal syncope

“…11 In a recent twin-family study, we provided strong evidence for a genetic etiology of VVS especially if syncope was frequent, or if typical vasovagal triggers were present. 11 In a recent twin-family study, we provided strong evidence for a genetic etiology of VVS especially if syncope was frequent, or if typical vasovagal triggers were present.…”

Genetics of the Faint-Hearted

“…3,6 Despite these findings, the role of genetic factors and the model of inheritance of vasovagal syncope are unknown.…”