THE LEFT VENTRICULAR REMODELING AMONG PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION BY GENE POLYMORPHISMS RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i3.11598Keywords:
heart remodeling, renin-angiotensin-aldosterone system, gene, atrial fibrillation, echocardiographyAbstract
Modern important medical and social problems in the world are hypertension, coronary heart disease (CHD) and atrial fibrillation (AF). Gene polymorphisms can contribute to the occurrence of arrhythmias, especially the study of the role of genes of the renin-angiotensin-aldosterone system (RAAS), because at present, its role in the pathogenesis of AF combined with hypertension is defined as leading. Currently, there is limited data on the relationship of left ventricular hypertrophy among patients with comorbid pathology, which indicates the need to determine population characteristics in studying the role of gene polymorphisms in the development of multifactorial diseases such as CHD and hypertension and their complications, which induces a great practical interest.
The aim of the study – to determine the features of left ventricular remodeling in patients with paroxysmal atrial fibrillation with gene polymorphisms of the renin-angiotensin-aldosterone system.
Material and Methods. To achieve this goal, a prospective, open comparative study was conducted on the basis of the City Hospital No. 10 of Zaporizhia City Council. The sample of patients was conducted in the period from 2014 to 2019. The results of the study are based on data from a comprehensive examination and dynamic monitoring of 176 patients with paroxysmal AF on the background of coronary heart disease and hypertension, of whom 98 were from Zaporizhzhia and 78 were from rural areas. The division of patients into groups was performed after establishing the compliance of patients with the inclusion/exclusion criteria of the study depending on the combination of the genotype of gene polymorphisms. All subjects underwent echocardiographic examination, determination of gene polymorphism.
Results. It was found that genetic polymorphisms of the renin-angiotensin-aldosterone system can affect the severity of pathological changes in patients with paroxysmal AF on the background of coronary heart disease and hypertension. It was determined that the T174M polymorphism of the angiotensinogen gene affects the indicators of left ventricular remodeling. In patients with allelic gene M, the left ventricular myocardial mass index was significantly higher. The study of A1166C polymorphism of the AGTR1 gene allows to predict the risk of adverse concentric remodeling of the left ventricle, in the presence of a patient with the allelic gene C increases the risk by 2.03 times.
Conclusions. Thus, studying the influence of these polymorphisms on the activity of the cardiovascular system should take into account the genetic characteristics of individual ethnic groups and populations. The obtained results allow us to consider gene polymorphisms as an additional factor in predicting the formation of inadequate left ventricular mass, which leads to its unfavorable remodeling.
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