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Interrelation of polymorphic variants of АСЕ (I / D), AGT (M235T) and beta2-АР (Q27E and G16R) with the clinical phenotype of systolic CHF patients

Krasnova O. A., Sitnikova M. Yu., Ivanov S. G.
Federal State Budgetary Institution, “North-West Federal Medical Research Center” of the RF Ministry of Health Care, Akkuratova 2, St.-Petersburg 197341

Keywords: AGT(М235Т), ACE (D/I), beta2-АР (Q27E, G16R), nonmodifiable and modifiable characteristics of patients, polymorphic variants of genes, CHF

DOI: 10.18087/rhfj.2012.4.1712

Relevance. A considerable number of papers study the connection of polymorphic markers of candidate genes and phenes of CHF patients, but there is no common opinion about influence of candidate genes of the main systems participating in pathogenesis of this disease on the CHF patients’ phenes. Objective. Reveal interrelation of the polymorphic variants of ACE genes (I / D), AGT (M235T), β2‑АР (Q27E and G16R) with clinical laboratory and structural functional indices of the patients with systolic CHF of ischemic etiology. Materials and methods. The analysis of clinical laboratory and instrumental parameters of 135 male patients with systolic CHF was carried out. Average age 59.9±7.0 years, II–IV FC CHF, LVEF ≤45 %. Patients received standard therapy in the highest tolerated doses. Polymorphic region of the studied gene was amplified by PCR method with a subsequent restriction analysis. Results. The patients who have genotype-II of ACE gene made 23 %, genotype-ID – 46.7 %, genotype-DD – 30.3 %. Genotype-MM of AGT gene was found in 24.4 % cases, genotype-MT – in 52.6 % cases, genotype-TT – in 23 % cases. Persons with genotype-QQ of β2‑АР gene were found in 14.1 % cases, genotype-QE – in 65.9 % cases, genotype-EE – in 20 % of cases. Patients with genotype-GG of β2‑АР gene made 17 %, genotype-GR – 60 %, genotype-RR – 23 %. In CHF patients who have genotype-DD, DM type 2 was found more often than in the group of patients with genotypes II and ID (р=0.05), patients with D-allele or T-allele in comparison with the patients who have genotype-II or genotype-MM had ACVD more often, р=0.05 and р=0.01, respectively. Prescription of AH before development of CHF was significantly longer and there was a tendency to higher LVEF in persons with genotype-DD, than at those who have at least one I-allele (р1=0.03 and р2=0.07, respectively). In the group of patients with genotype-GR, there were registered more cases of AH (р=0.01) in comparison with homozygous carriers of this polymorphism. Conclusion. Distribution of genotypes of polymorphic variants of ACE (D / I), AGT (М235Т) and β2‑АР (Q27E, G16R) genes in the studied sample of CHF patients who reside in St.‑Petersburg corresponds to the data of the European population. In male patients with systolic CHF, presence of AH in the anamnesis has been connected with presence of genotype-GR of β2-АР gene, and in carriers of D allele of ACE gene, development of CHF against past AH slowed down. ACVD risk in patients from the studied cohort was associated with presence of D allele of ACE gene and genotype-MM of AGT gene, and presence of DM type 2 – with genotype-DD carriage.
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Krasnova O. A., Sitnikova M. Yu., Ivanov S. G. Interrelation of polymorphic variants of АСЕ (I / D), AGT (M235T) and beta2-АР (Q27E and G16R) with the clinical phenotype of systolic CHF patients. Russian Heart Failure Journal. 2012;13(4):200-204

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