Takotsubo syndrome and estrogen receptor genes: partners in crime?

Aims We aimed to analyze genetic polymorphism of estrogen receptor (ESR) 1 and ESR2 in a series of postmenopausal women with Takotsubo syndrome (TS). Methods In total, 81 consecutive white women were prospectively enrolled: 22 with TS (TS group; mean age 71.2 +/- 9.8 years), 22 with acute myocardial infarction (MI group; mean age 73.2 +/- 8 years), and 37 asymptomatic healthy controls (CTRL group; mean age 69 +/- 4.2 years). Genotyping of ESR1 -397C>T (rs2234693) and -351A>G (rs9340799) and ESR2 -1839G>T (rs 1271572) and 1082G>A (rs1256049) genetic variants was performed. We estimated the odds ratio (OR) between the genotype of each examined locus with the occurrence of TS or MI. Results The risk of experiencing TS was higher for those study participants carrying the T allele at the rs2234693 locus of the ESR1 gene [OR: 2.0, 95% confidence interval (CI): 0.973-4.11, P=0.04, TS vs. MI+CTRL; OR: 2.79, 95% CI: 1.17-6.64, P=0.016, TS vs. MI alone]. Women carrying a T allele at the rs1271572 locus of the ESR2 gene demonstrated an even higher risk (OR: 3.23, 95% CI: 1.55-6.73, P=0.0019, TS vs. MI+CTRL; OR: 9.13, 95% CI: 2.78-29.9, P=0.0001, TS vs. MI alone). Conclusion The study reports preliminary findings suggesting a possible link between ESR polymorphisms and the occurrence of TS. Larger studies are needed to confirm our results.