The recessive pattern of inheritance of аldosterone synthase gene and indicators of diastolic function of left ventricle in patient with coronary heart disease and postinfarction cardiosclerosis
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Abstract
The aim – was to investigate the possible association of the aldosterone synthase gene (CYP11B2) polymorphism and the recessive pattern of inheritance with left ventricular diastolic function in patients with coronary heart disease and postinfarction cardiosclerosis (PIC).
Material and methods. One hundred patients (age 57.3±8.9 years) were examined by general clinical methods. The study included patients with a history of myocardial infarction for more than 6 months and up to 2 years from the date of the event. Genetic testing was performed by polymerase chain reaction in real mode. The study material was venous blood of patients with coronary heart disease, PIC. Echocardiography was done for the evaluation of diastolic function in all patients.
Results. The E wave velocity parameters were higher among patients with TT + TC genotype compared to the data of patients with CC genotype. The wave-velocity parameters A were higher, and DT was longer in patients with CC variant of the genotype compared to the TT + TC variant of the aldosterone synthase gene polymorphism, which indicates a greater frequency of LV relaxation disturbance in patients with CC variant of polymorphism compared to TT + TC variant of the genotype. The indices of higher diastolic LV diastolic pressure, an increase in its preload (E/E´, AR) were higher in the group of patients with TT and TC, a variant of aldosterone synthase gene polymorphism. The patients with
TT + TC variant of polymorphism more often encountered more severe forms of LV diastolic dysfunction (pseudonormalization, restriction) compared with the data of patients with a variant of polymorphism of the aldosterone synthase gene (P<0.0001), which indicates a more severe course of the disease in these patients.
Conclusion. The risk of developing more severe forms of diastolic LV dysfunction in patients with TT + TC genotype CYP11B2 is higher, compared to the CC genotype in patients with IHD, PIC.
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References
Лобач Л.Є., Досенко В.Є., Долженко М.M. Варіанти поліморфізму гена альдостеронсинтетази (CYP11B2) та основні фактори серцево-судинного ризику // Запорож. мед. журн.– 2016.– № 6 (99).– С. 4–11.
Лобач Л.Є., Досенко В.Є., Долженко М.М. Вплив поліморфізму гена альдостеронсинтази (CYP11B2) на ризик розвитку інфаркту міокарда // Укр. кардіол. журн.– 2017.– № 2.– С. 26–30.
Aljaroudi W., Alraies M.C., Halley C. et al. Impact of progression of diastolic dysfunction on mortality in patients with normal ejection fraction // Circulation.– 2012.– Vol. 125.– P. 782–788.
Brown N.J. Eplerenone: Cardiovascular protection // Circulation.– 2003.– Vol. 107.– P. 2512–2518.
Davies E., Holloway C.D., Ingram M.C. et al. Rapid detection of rate and blood pressure in essential hypertension are related to the hypertension associated M235-Thr allele of the human angiotenpolymorphic differences in the aldosterone synthase gene CYP11B2 // Hum. Mol. Genet.– 1993.– Vol. 2.– P. 609–610.
De Faire U., Prince J. Genes and environment behind ethnical differences in variations in left ventricular mass // J. Hypertens.– 2004.– Vol. 22.– P. 241–243.
Delyani J.A. Mineralocorticoid receptor antagonists: The evolution of utility and pharmacology. Kidney Int 2000.– Vol. 57.– P. 1408–1411.
Epstein M. Aldosterone and the hypertensive kidney: Its emerging role as a mediator of progressive renal dysfunction – a paradigm shift // J. Hypertens.– 2001.– Vol. 19.– P. 829–842.
Hautanena A., Lankinen L. Kupari M. et al. Associations between aldosterone synthase gene polymorphism and the adrenocortical function in males // Intern Med. 1998.– Vol. 244.– P. 11–18.
Hillis G.S., Moller J.E., Pellikka P.A. et al. Noninvasive estimation of left ventricular filling pressure by E/E0 is a powerful predictor of survival after acute myocardial infarction // J. Amer. Coll. Cardiol.– 2004.– Vol. 43.– P. 360–367.
Nagueh S.F., Smiseth O.A., Appleton C.P. et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Associationof Cardiovascular Imaging // J. Am. Soc. Echocardiogr.– 2016.– Vol. 29.– P. 277–314.
Safar M.E., Cattan V., Lacolley P. et al. Aldosterone synthase gene polymorphism, stroke volume and age-related changes in aortic pulse wave velocity in subjects with hypertension // J. Hypertens.– 2005.– Vol. 23.– P. 1159–1166.
Safar M.E., Millasseau S., Mahmud A. et al. Relations between large artery structure and function and aldosterone // J. Hypertens.– 2011.– Vol. 29.– P. 1676–1683.
Somaratne J.B., Whalley G.A., Gamble G.D., Doughty R.N. Restrictive filling pattern is a powerful predictor of heart failure events post acute myocardial infarction and in established heart failure: a literature-based metaanalysis // J. Card. Fail.– 2007.– Vol. 13.– P. 346–352.
Weber K.T., Sun Y., Campbell S.E. et al. Chronic mineralocorticoid excess and cardiovascular remodeling // Steroids.– 1995.– Vol. 60.– Р. 125–132.