112 ApoE polymorphism in dilated cardiomyopathy and advanced heart failure

Abstract

Background: ApoE plays, beside its effect on cholesterol metabolism, a role in downregulation of inflammatory response. Recently has been observed that apoE4 is less effective in suppressing neuroinflammatory activation than apoE3 or apoE2. Aim of the study was to describe apoE polymorphism in patients with advanced heart failure based on dilated cardiomyopathy (DCM) and to evaluate relationships between ApoE polymorphism and the selected clinical variables. Patients and Methods: Fifty patients (43 males) with advanced heart failure caused by DMC (mean age 49.7± 6.1 years) were included. All of them were Caucasians. Diagnosis of DCM was based on echocardiography; coronary angiogram was normal in all of the patients. The mean left ventricular ejection fraction was 24.8±7%, and mean NYHA class was 2.9± 0.6. For identification of the gene polymorphism CVD StripAssay (ViennaLab, Labordiagnostika, GmbH) was used. The method is based on polymerase chain reaction and subsequent reverse hybridization. The associations between apoE polymorphism and serum levels of C-reactive protein (CRP), hemoglobin (HB), uric acid (UA), total cholesterol (TC) and lymphocyte count (LC) were evaluated. Results: Frequency of the ApoE4 allele was 40%. Frequency of the genotype e2/4 and e3/4 was 58% and 22%, resp. Genotypes e4/4 or e2/2 were not found. Reported frequency of the ApoE4 allele in healthy Caucasians is 14.7%, the frequency of genotype e2/4 and e3/4 is 2.1% and 22.5%, resp. Individuals carrying apoE4 allele (e2/4, e 3/4) (n=37) were compared with individuals without apoE4 allele (e2/3, e 3/3) (n=13). Significant differences in the serum CPR (5.1± 2.4 g/l vs 3.5±2.5 g/l; p<0,05) and the serumUA (399±126 vs 498±158μmol/l; p<0,05) were found. No statistical differences of LC, Hb or TC levels were observed between the groups. Conclusion: High frequency of ApoE4 allele in patients with advanced heart failure due to DCM is striking. It appears that presence of ApoE4 allele is associated with signs of increased inflammatory activity.