Аldosterone synthetase gene (CYP11B2) polymorphism and structural parameters of the left ventricle in patients with coronary heart disease, postinfarction cardiosclerosis
DOI:
https://doi.org/10.14739/2310-1210.2017.6.114676Keywords:
gene polymorphism, CYP11B2-344C/T, ischemic heart disease, sclerosis, іnfarction risk factors, structural characteristics of the left ventricleAbstract
Purpose of the work – to investigate the possible contribution of aldosterone synthetase gene (CYP11B2) polymorphism to the disease course and structural parameters of LV in patients with coronary heart disease, postinfarction cardiosclerosis.
Materials and мethods. General clinical examination of 100 patients with postinfarction cardiosclerosis was done at the Cardiology Department of P. L Shupyk NMAPE. Genetic testing was performed by polymerase chain reaction in real time at the Bogomolets Institute of Physiology,Kyiv,Ukraine.
Exclusion criteria were hemodynamically significant valvular heart diseases, chronic obstructive pulmonary diseases, permanent or temporary heart pacing, acute heart failure and implanted cardioverter-defibrillator, permanent atrial fibrillation.
Statistical analysis of the results was performed using Microsoft Excel, the statistical program SPSS (version 20, US). The results obtained are presented as M ± σ.
Results. The stenosis of the left main coronary artery was observed in 25.9 % of cases in the subgroup of the TT variant. It should be noted that in the TC subgroup of aldosterone synthase gene variant polymorphism the incidence of the left main coronary artery lesion was 13.9 %. There has been no single case of left main coronary artery lesion in the SS subgroup with little statistical significance in comparison with the subgroup of TT variant of the polymorphism (P = 0.048). In the analysis of clinical data the most marked manifestations of angina pectoris were in subgroups of TT and TC – 73.3 % and 72.7 %, respectively, compared with CC subgroup – 40 %, reliable for both subgroups (P1.2 = 0.95, P1.3 = 0.039, P2.3 = 0.029). In the analysis of LV morphological characteristics the smallest indices of the LV mass have been revealed in the CC subgroup of the polymorphism variant (190.5 ± 52.1 g), compared with the LV mass values in the TT subgroup (231.00 ± 55.21 g, P = 0.03) and TC (197.421 ± 63.15, P > 0.05). A statistically significant difference has been also observed between the TT and TC subgroups of the polymorphism variant data (P = 0.01). The smallest index of LV myocardial mass has been revealed in the TC subgroup of the polymorphism variant compared with the TT variant subgroup (98.0 ± 29.25 versus 113.33 ± 26.63 g/m2, P = 0.017).
In the analysis of left ventricle diastolic diameter index between subgroups of polymorphism the smallest parameter was in the CC subgroup of polymorphism with a significant difference in comparison with the data of the aldosterone synthetase gene polymorphism TC subgroup patients (2.38 ± 0.17 vs. 2.56 ± 0.26 cm/m², respectively, P = 0.02). The lowest left ventricle systolic diameter index was detected in CC variant of aldosterone synthetase gene polymorphism subgroup in comparison with the data of patients in the TT and TC variants of aldosterone synthetase gene polymorphism subgroups (1.51 ± 0.2 vs. 1.88 ± 0.5 and 1.83 ± 0,37 cm/m², p1.3 = 0.02 and p2.3 = 0.005). The smallest left ventricle diastolic volume index was also found in the CC variant of aldosterone synthetase gene polymorphism subgroup in comparison with the other two subgroups data with a significant difference in the data of TC variant of aldosterone synthetase gene polymorphism patients (54.2 ± 10.7 versus 68.1 ± 17.7 ml/m², P = 0.01).
Conclusions. Patients with TT and TC variants of aldosterone synthetase gene polymorphism demonstrated higher incidence of the left main coronary artery lesion in comparison with the patients of the CC variant of aldosterone synthetase gene polymorphism subgroup, who have not had atherosclerotic lesion of the left main coronary artery.
In patients with TT and TC variants of aldosterone synthetase gene polymorphism manifestations of angina pectoris had a higher gradation compared to the CC variant of aldosterone synthetase gene polymorphism.
Significantly lower values of left ventricle diastolic diameter index, systolic diameter index and diastolic volume index have been found in the CC variant subgroup in comparison with TT variant.
Patients in TT variant of polymorphism subgroup had significantly reduced ejection fraction in comparison with the CC subgroup.
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