In the development of essential hypertension cardiac remodeling is determined by both hemodynamic and neurohumoral factors. The influence of hemodynamic factors is sufficiently studied, while the role of stimulating and inhibiting humoral agents in the development of cardiac remodeling is completely unknown. Therefore, the study of structural and functional indicators of the myocardial state in patients with essential hypertension and heart failure being carriers of different BNP genotypes is promising in terms of the possible role of the BNP gene polymorphisms in the development and progression of cardiac disease manifestations.
The objective of the research was to examine structural and functional indicators of the myocardial state in men with essential hypertension and co-existent chronic heart failure Class IIА being carriers of different variants of the brain natriuretic peptide gene at the age of 40-60 years living in Podillia region.
Materials and methods. Genotyping of the brain natriuretic peptide gene was performed using the polymerase chain reaction. Structural and functional indicators of the myocardial state were assessed by cardiac ultrasound with ultrasound device ULTIMA RA (Radmir, Ukraine).
Results. The results revealed that among men with stage II essential hypertension the frequency of the T381T genotype of the brain natriuretic peptide gene was 35.48% and 64.52% of patients were carriers of C allele (р<0.001); among patients with essential hypertension and co-existent chronic heart failure Class IIА the frequency of the T381T genotype was 42.00% and 58.00% of patients were carriers of C allele (р≤0.05). In patients with chronic heart failure Class IIА being carriers of the T381T genotype the size and volume of the left ventricle at the end of systole and diastole were significantly larger, the indicators of the left ventricular myocardium mass index and left ventricular wall thickness were higher than in carriers of C allele (р<0.05). The indicators of the size and volume of the left ventricle, posterior left ventricular wall thickness and systemic hemodynamics regardless of the brain natriuretic peptide genotype were significantly higher in men with essential hypertension and co-existent chronic heart failure Class IIА compared to patients with stage II essential hypertension (p<0.05).
Conclusion. In patients with symptoms of chronic heart failure Class IIA being carriers of the Т381Т genotype the size and volume of the left ventricle at the end of systole and diastole were significantly larger, the indicators of the left ventricular myocardium mass index and left ventricular wall thickness were higher than in carriers of C allele of the brain natriuretic peptide gene (р<0.05). In patients with essential hypertension and co-existent chronic heart failure Class IIА EF<45% being carriers of the Т381Т genotype, the highest indicators of the size of the left ventricle, end-systolic volume index, end-diastolic volume index, left ventricular myocardium mass index were observed. The inheritance of the T381T genotype by patients with symptoms of chronic heart failure Class IIA was found to be associated with higher levels of systolic blood pressure and diastolic blood pressure irrespective of the state of left ventricular systolic function.
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