Abstract
One of the main etiological causes of development of heart failure is essential hypertension. The diagnosis of heart failure is usually made on the basis of comprehensive analysis of medical history, sonographic and biochemical examination. Normal ejection fraction does not exclude dyspnea of cardiac origin. Objective: to determine the role of galectin-3 as a marker of structural and functional changes of the myocardium in males with essential hypertension and CHF, carriers of polymorphic AT1R genes, residents of Podillya region of Ukraine. In this contingent, the surveyed were studied сoncentrations of galectin-3 and brain natriuretic peptide (BNP), parameters of central and systemic hemodynamics in carriers of polymorphic variants of angiotensin II type 1 receptor gene (АТ1R) - individuals with no cardiovascular pathology (n=79), male patients with II-III degree essential hypertension (EH) and hypertrophy of the myocardium (n=62), and essential hypertension (n=50) complicated by chronic heart failure (CHF), residents of Podillya region of Ukraine, were studied. Genotyping of АТ1R gene was performed using polymerase chain reaction. Galectin-3 and brain natriuretic peptide levels were determined by enzyme immunoassay. Structural and functional parameters of myocardium were assessed by ultrasound using the apparatus “RADMIR ULTIMARA”. Statistical analysis of the results obtained was done on personal computer using standard statistical package Statistica 10.0. The data are represented as mean values (M) and standard deviations (±m). Carriers of C allele of angiotensin II type 1 receptor gene were found to be dominating among the males with essential hypertension and resultant myocardial hypertrophy. Concentrations of galectin-3 and brain natriuretic peptide were significantly higher in men with essential hypertension and essential hypertension associated with chronic heart failure, as compared to those with no cardiovascular diseases, as well as the carriers of C allele of angiotensin II type 1 receptor gene. It was found that concentrations of study biomarkers were higher in individuals with severe and eccentric left ventricular hypertrophy, as well as in those with decreased ejection fraction of the left ventricle. Therefore, those biomarkers can be used in complex diagnosis of left ventricular hypertrophy in essential hypertension and the development of chronic heart failure in such patients.
Highlights
Over the last decades, heart failure (HF) has become the most significant and rapidly progressive medical, and an important social problem in many economically developed countries, as it leads to early disability of patients, reduced quality of life and its duration [29]
Predominance of genotype frequency which include С allele of angiotensin II type 1 receptor gene (AT1R) gene was found in males with essential hypertension (EH) and chronic heart failure (CHF), included in study population, (Fig. 1), this being consistent with other authors
To make further analysis easier both in patients with EH, and EH and CHF, as well as in the group of individuals with no cardiovascular disease, - those with genotypes which include C allele (А1166С and С1166С), it was decided to combine them in one group - the carriers of АТ1R gene C allele
Summary
Heart failure (HF) has become the most significant and rapidly progressive medical, and an important social problem in many economically developed countries, as it leads to early disability of patients, reduced quality of life and its duration [29]. According to the European Society of Cardiology (ESC) [22], essential hypertension is a major cause of CHF. In some patients, the signs of inadequate blood supply are observed even in slightly modified or normal LV systolic function. The percentage of this group of patients is quite high - 35%-50% [15]. Asymptomatic diastolic dysfunction (DD) occurs in 28% of American population (age 67 years), and in 27% of European population (age 58 years). Success in timely diagnosis, prevention and treatment of EH and CHF on its background, are closely related to study of mechanisms of their development and progression [2, 22]
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