Русский
Association of I/D polymorphism of ACE gene with different course of chronic heart failure and myocardial remodeling in patients with coronary heart disease after coronary artery bypass grafting
DOI: https://dx.doi.org/10.18565/therapy.2024.6.66-75
Magamadov I.S., Skorodumova E.A., Kostenko V.A., Pivovarova L.P., Ariskina O.B., Siverina A.V., Skorodumova E.G.
I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine
The aim: to determine the effect of I/D gene polymorphism at myocardial remodeling and peculiarities of CHF clinical course in patients with stable coronary heart disease (CHD) after coronary artery bypass grafting (CABG).
Material and methods. 105 patients with coronary heart disease were included in prospective study. Patients underwent genetic testing to determine I/D polymorphism (rs1799752) of ACE gene, and echocardiography.
Results. Depending on the genotypes of rs1799752 polymorphic variant of ACE gene, patients were divided into two groups. The 1st group included 57 patients with II and ID genotypes (78% male, 22% female patients, average age 63 ± 8 years), the 2nd group included 48 patients with the DD genotype (79% males, 21% females, average age 61 ± 7 years). Unlike the 1st sample, where no statistically significant changes in the volumes and sizes of the left ventricle (LV) were detected, in the 2nd group there was progression of LV remodeling: before CABG, the LV end-diastolic volume was 107.9 ± 5.8 ml, LV end-systolic volume 53.9 ± 4.9 ml, LV end-diastolic size 51.1 ± 1.3 mm, LV end-systolic size 36.4 ± 1.8 mm, after 18 months after CABG – 128.3 ± 7.6 ml, 66.1 ± 6.8 ml, 54.1 ± 1.2 mm and 38.3 ± 1.8 mm, respectively (p < 0.05). Quality of life according to the Minnesota scale before CABG in the 1st cohort was 28.8 ± 2.2, after 18 months – 19.9 ± 1.8 points (p < 0.001). In group 2, similar indexes were 27.4 ± 2.7 and 22.4 ± 2.3 points, respectively (p > 0.05). In 18 months of observation, acute decompensation of CHF (ADCHF) was registered in 10.7% of patients in the 1st sample and in 30.4% in the 2nd sample (odds ratio 3.27; 95% confidence interval: 1.05–10.57; p = 0.022).
Conclusion. In patients with DD genotype of ACE gene, an increase of LV size and volume, LV diastolic function deterioration, and also a three-time increase of ADHF-developing chances within 18 months observations after CABG are taking place. Life quality according to Minnesota scale in the long-term period after CABG among patients with II and ID genotypes became significantly better than in patients with the DD genotype.
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About the Autors
Isa S. Magamadov, MD, junior researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3A Budapeshtskaya St.
E-mail: isamagamadow17@gmail.com
ORCID: https://orcid.org/0009-0007-7895-0750
Elena A. Skorodumova, MD, PhD (Medicine), leading researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3A Budapeshtskaya St.
E-mail: elskor@mail.ru
ORCID: https://orcid.org/0000-0002-5017-0214
Viktor A. Kostenko, MD, PhD (Medicine), head of the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3A Budapeshtskaya St.
Email: vic2012tor@gmail.com
ORCID: https://orcid.org/0000-0002-7015-1010
Lyudmila P. Pivovarova, MD, Dr. Sci. (Medicine), head of the Department of laboratory diagnostics, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3A Budapeshtskaya St.
E-mail: pivovaroval@yandex.ru
ORCID: https://orcid.org/0000-0002-9492-4516
Olga B. Ariskina, MD, PhD (Biology), researcher at the Department of laboratory diagnostics, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3A Budapeshtskaya St.
E-mail: olga.ariskina@mail.ru
ORCID: https://orcid.org/0000-0001-6311-1259
Anna V. Siverina, MD, PhD (Medicine), researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3A Budapeshtskaya St.
E-mail: gudkovanna_09@mail.ru
ORCID: https://orcid.org/0000-0002-6831-2153
Elizaveta G. Skorodumova, MD, PhD (Medicine), researcher at the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192242, Saint Petersburg, 3A Budapeshtskaya St.
E-mail: Lisavetta91@mail.ru
ORCID: https://orcid.org/0000-0002-4961-5570
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