2013


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2013/№1

Role of evaluation of adrenoreactivity and beta2-adrenoreceptor polymorphism in the development of myocardial remodeling in patients with chronic heart failure

Khazova E. V., Bulashova O. V., Oslopov V. N., Kravtsova O. A.

Keywords: gene polymorphism, myocardial remodeling, CHF

DOI: 10.18087/rhfj.2013.1.1780

Relevance. Now there is no doubt that polymorphism of multiple modifier genes can considerable influence phenotypic manifestations of CVD, including CHF. Considering hypersympathicotonia typical for HF patients, it is important to study functional status of beta-adrenoreceptors. Objective. Study of association of polymorphic markers beta-adrenoreceptors type 2 (ADRB2) with phenotypic manifestations and functional peculiarities of LV myocardium in CHF patients and diverse beta-adrenoactivity of organism. Materials and methods. 132 patients with CHF were examined (46.2 % male and 53.8 % female). FC distribution: I – 3 %, II – 46 %, III – 45 %, IV – 6 %. In all patients, beta-adrenoactivity of organism was assessed, PCR genetic typing was carried out by Arg16Gln and Gln27Glu and ADRB2 gene polymorphic markers. Myocardial structure was studied by EchoCG. Results. Differences in the geometrical models of LV myocardial remodeling was revealed: in patients with normal beta-ARM levels, concentric type prevailed (70 %), in patients with reduced beta-ARM levels – excentric LV hypertrophy (79 %). Genotype study showed higher prevalence of Arg allele in 16 in polymorphic locus in CHF patients. In comparison with the reference group: Arg / Arg (42 and 18 %), Arg / Gln (49 and 38 %) and Glu27Glu (30 and 10.7 %), Glu27Gln (54.5 and 46.9 %). Gln16Gln and Gln27Gln genotypes were rarer, than in the reference group (9 and 44 %) and (15.5 and 42.4 %). Correlation analysis revealed positive interrelation between beta-ARM and SHOKS (r=0.37, р<0.05), LVEF (r=0.28, р<0.05) and RV dimensions (r=0.20, р<0.05), negative correlation with 6 minute walk test results (r= –0.43, р<0.05). Conclusion. Decrease of beta-adrenoactivity is more typical for patients with sever CHF due to CHD, often with postinfarction cardiosclerosis. In CHF patients with decreased beta-adrenoactivity, mainly excentric type of left ventricular hypertrophy is observed. In the group of patients with normal beta-ARM levels, concentric LV remodeling prevails. Decrease of beta-adrenoactivity is revealed in 55 % of patients with Аrg16Gly genotype and in all patients with Gln / Gln genotype, which may reflect protective desensitization of cell membrane in patients of this group. Glu27Glu genotype frequency rate is higher in the group of patients with decreased beta-ARM levels at comparison with the group with normal beta-ARM levels and reference group.
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Khazova E. V., Bulashova O. V., Oslopov V. N. et al. Role of evaluation of adrenoreactivity and beta2-adrenoreceptor polymorphism in the development of myocardial remodeling in patients with chronic heart failure. Russian Heart Failure Journal. 2013;14 (1):34-39

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