International Journal of Collaborative Research on Internal Medicine & Public Health

Value of Angiotensin-Converting Enzyme and Monoxide Nitrogen in Pathogenesis of Myocardium Remodeling Depending on Genes' Polymorphism of Асе (I/D) and eNOS (894T>G) in Patients with Arterial Hypertensio n

Introduction: Humans genes mutations in altered social conditions through interaction with environmental factors and harmful habits become an individual risk factor.

Objectives: To evaluate Angiotensin-Converting Enzyme (ACE) and nitrogen monoxide metabolites (NO/NO2 -/NO3 -) blood levels depending on I/D polymorphism of ACE gene (dbSNP id:rs4646994), 894T>G of Endothelial Nitric Oxide Synthase (eNOS, dbSNP id:rs1799983) in pathogenesis of left ventricular hypertrophy (LVH) in patients with Essential Arterial Hypertension (EAH).

Methods: 120 screened patients with EAH I-III stages (48.3% – women, 51.7% – men, average age 52.9±9.24 years) and 40 healthy persons participated in prospective study. Alleles of polymorphic locus were studied by PCR method. Serum ACE level was detected by ELISA. Plasma NO metabolites levels were determined by colorimetric method. Structural myocardium changes – by EchoCG, ECG. Results analyzed according to the European guidelines ESC/ESH (2009).

Results: D-allele presence (ACE) associated with high risk of LVH geometric patterns and higher level of ACE. Presence of TT-genotype of eNOS gene (ID/TT-haplotype) associated with lower levels of NO metabolites by 14.5% (?<0.05). Homozygous D-allele carriers (regardless of genotypes combination of eNOS gene – DD/TG, DD/GG haplotypes) have ACE concentration increased by 18.1% and 17.5%, accordingly (?<0.05). The absence of mutations in haplotypes (II/GG) is a protective factor against LVH (OR=0.13, p=0.047), with the lowest level of ACE, followed by higher concentration of NO metabolites (p<0.05). The combination of D+T allele in haplotypes (ID/TG, DD/TG ) increases the relative risk of LVH and EAH II and III in 1.19-2.25 times (OR=4.75-13.5, p≤0.021-0.001), which is confirmed by severity of clinical course, and increased ACE serum level (DD/TG carriers).

Conclusion: Risk groups for eccentric or concentric LVH models are D-allele carriers (ACE gene) with highest ACE level and T-allele of eNOS gene with lower concentration of NO metabolites.

Author(s):

Sydorchuk L.P. , Gaborec I.Y. , Sydorchuk A.R. , Bukach O.P. , Sokolenko A.A. , Ursuliak J.V. , Ivaschuk S.I. , Antoniuk M.V. , Yarynych J.M.

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