Open Access Research article

Low prevalence of connexin-40 gene variants in atrial tissues and blood from atrial fibrillation subjects

Gregory D Tchou1, Robert C Wirka2, David R Van Wagoner34, John Barnard5, Mina K Chung34 and Jonathan D Smith14*

Author affiliations

1 Department of Cell Biology, 9500 Euclid Ave, Cleveland, OH, 44106, USA

2 Cleveland Clinic Lerner College of Med of Case Western Reserve University, 9500 Euclid Ave, Cleveland, OH, 44106, USA

3 Department of Molecular Cardiology, 9500 Euclid Ave, Cleveland, OH, 44106, USA

4 Department of Cardiovascular Med, 9500 Euclid Ave, Cleveland, OH, 44106, USA

5 Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44106, USA

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Citation and License

BMC Medical Genetics 2012, 13:102  doi:10.1186/1471-2350-13-102

Published: 7 November 2012



The atrial gap junction protein connexin-40 (Cx40) has been implicated to play an important role in atrial conduction and development of atrial fibrillation (AF). However, the frequency of Cx40 mutations in AF populations and their impact on Cx40 expression remains unclear. In this study, we sought to identify polymorphisms in the Cx40 gene GJA5, investigate the potential functional role of these polymorphisms, and determine their allelic frequencies. The prevalence of nonsynonymous Cx40 mutations in blood and atrial tissue was also compared to mutation frequencies reported in prior studies.


We conducted direct sequencing of the GJA5 coding and 3 UTR regions in blood samples from 91 lone AF subjects and 67 atrial tissue-derived samples from a lone cohort, a mixed AF cohort, and several transplant donors. Reporter gene transfection and tissue allelic expression imbalance assays were used to assess the effects of a common insertion/deletion polymorphism on Cx40 mRNA stability and expression.


We identified one novel synonymous SNP in blood-derived DNA from a lone AF subject. In atrial tissue-derived DNA from lone and mixed AF subjects, we observed one novel nonsynonymous SNP, one rare previously reported synonymous SNP, and one novel 3 UTR SNP. A previously noted 25 bp insertion/deletion polymorphism in the 3 UTR was found to be common (minor allele frequency = 0.45) but had no effect on Cx40 mRNA stability and expression. The observed prevalence of nonsynonymous Cx40 mutations in atrial tissues derived from lone AF subjects differed significantly (p = 0.03) from a prior atrial tissue study reporting a high mutation frequency in a group of highly selected young lone AF subjects.


Our results suggest that Cx40 coding SNPs are uncommon in AF populations, although rare mutations in this gene may certainly lead to AF pathogenesis. Furthermore, a common insertion/deletion polymorphism in the Cx40 3 UTR does not appear to play a role in modulating Cx40 mRNA levels.

Atrial fibrillation; Connexins; Ion channels; Genetics; Allelic expression imbalance