The peculiarities of heart remodeling in patients after myocardial infarction with ST-segment elevation depending on the Lys198Asn polymorphism of endothelin 1 gene

Abstract

Objective — to investigate clinical and genetic aspects of associations of Lys198Asn endothelin 1 (EDN 1) gene polymorphism with the development of remodeling after myocardial infarction with ST-segment elevation (STEMI). Material and methods. The study involved 91 patients with STEMI, 70 (77 %) male and 21 (23 %) female, at average age (60.3 ± 9.4) years old after selective coronary angiography with infarct-related artery stenting. Polymerase chain reaction was used to determine allele polymorphism Lys198Asn of EDN 1 gene. The observation period duration was 6-month. Results and discussion. The association with the STEMI onset in male patients with Lys198Asn + Asn198Asn genotype of EDN 1 gene was in 3.19 times higher, then in female (c2 = 4.01, p = 0.043); at arterial hypertension presence — in 3.72 times (c2 = 4.31, p = 0.038), in tobacco smokers — in 2.06 (c2 = 4.66, p = 0.031), which was associated with more severe damages of the coronary arteries. In the acute STEMI period, the structural and functional data depending on polymorphous locus Lys198Asn of EDN 1 gene did not differ. After 6-month observations, in Asn-careers in comparison with Lys198sLys-careers, the increase in the left ventricular size and cavity volumes, and myocardial mass, as well as left atrium diameter. That is, there was a tendency to a progressive process of myocardial remodeling and the development of chronic heart failure. Conclusions. In patients after STEMI polymorphous Lys198Asn + Asn198Asn of EDN 1 gene in comparison with Lys198Lys genotype associated with the individual propensity to the formations of left ventricular dilatation and hence, the unfavorable (maladaptive) post infarctional remodeling.