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Shalimova Cardiovascular remodeling in EH and DM2

artery) was performed using a phased transducer with disorders than patients with the A/A genotype. No
a frequency of 2-4 MHz. An A1166C polymorphism significant differences in hemodynamic and metabolic
of the AGTR1 gene and a Pro12Аla polymorphism parameters between the C/C and A/C genotypes were
of the PPARγ2 gene were assessed by the molecular found [Table 2].
genetic method. Three genotypes of the AGTR1 gene
(A/A, A/C and C/C) were identified, along with three Given that A/C and C/C genotypes presented
genotypes of the PPARγ2 gene (Pro/Pro, Pro/Аla and significantly different characteristics from the
Ala/Аla). Processing of statistical data was performed A/A genotype, with more severe disorders of
using the software package “Statistics for Windows echocardiographic and biochemical parameters, but
6.0”. The values are presented as the average value of were not significantly different from each other, in
parameters (M) and standard error (m). the next step of the study, patients with A/C and C/C
genotypes were merged into a single group, namely
The study protocol was approved by the Ethics the A/C + C/C genotype.
Committee of the Kharkiv National Medical University.
All participants were informed about the aim of the For establishing associations of AGTR1 polymorphisms
study and signed a written consent form. with cardiovascular remodeling, a comparative
evaluation of echocardiographic parameters and
RESULTS indicators of the structural and functional state of the
heart and blood vessels of the main group of patients,
Evaluation of the A1166C polymorphism of the AGTR1 with different genotypes, was performed [Table 3]. It
was found that patients with the A/C + C/C genotype
gene in patients with comorbidity of EH and DM2, had significantly larger LV compared to the A/A
compared to the distribution of alleles and genotypes in genotype (P < 0.01). Thus, patients with the A/C +
healthy individuals, and in patients with EH but without
DM2, showed that 61.6% of patients with EH and DM2, C/C genotype also had significantly (P < 0.05) greater
MMILV compared to the A/A genotype. In addition, the
and 57.8% of patients with EH without DM2, had A/C A/C + C/C genotype had significantly (P < 0.05) lower
and C/C genotypes of AGTR1, which have been shown values of the diastolic function indicator E/A.
to be associated with cardiovascular complications
by some researchers. [9,10] The genotypes of the main Assessment of the great vessels showed that IMT
group (P < 0.01) and the comparison group (P < 0.05) in the main group of patients with the genotype A/C
were significantly different from the control group. The + C/C was significantly (P < 0.001) greater than the
C allele was established in 33.1% of patients with EH genotype A/A [Table 3]. The study did not reveal any
and DM2, and 31.1% of patients with EH without DM2; significant differences in PWV values in the carotid
in the control group, the C allele was significantly less artery or the abdominal aorta in the diverse AGTR1
present (P < 0.05) [Table 1]. genotypes. It should be noted that in patients with EH
with concomitant DM2 and genotype A/C + C/C, the
In the next step of the study, hemodynamic and level of EDVD was significantly (P < 0.001) lower than
metabolic parameters in patients with comorbidity of the genotype A/A.
EH and DM2, in different polymorphism variants of the
AGTR1 gene, were compared [Table 2]. In the next step of the study, the Pro12Ala
polymorphism of PPARγ2 was estimated and
Patients with A/C and C/C genotypes of the AGTR1 compared with the distribution of alleles and
gene had higher blood pressure (P < 0.001) compared genotypes in healthy individuals and in patients with
to the A/A genotype. These patients also had EH without DM2 [Table 4].
significantly larger LV and myocardial mass index left
ventricle (MMILV), and a greater IMT, with a lower It was found that, in all study groups, patients with
rate of EDVD. Patients with the indicated genotypes the Pro allele were predominant (86.6% in the main
also had significantly more pronounced metabolic group, 85.6% in the comparison group and 87.1% in

Table 1: The distribution of AGTR1 alleles and genotypes in the patients, n (%)
Indices Main group (n = 320) Comparison group (n = 90) Control group (n = 31)
A allele 214 (66.9)* 62 (68.9)* 25 (80.6)
C allele 106 (33.1)* 28 (31.1)* 6 (19.4)
A/A genotype 123 (38.4)* 38 (42.2)* 20 (64.5)
A/C genotype 182 (56.9)* 49 (54.5)* 10 (32.3)
C/C genotype 15 (4.7) 3 (3.3) 1 (3.2)
*P < 0.05 vs. the control group
86 Vessel Plus ¦ Volume 1 ¦ June 27, 2017