Franchuk S. The inheritance of angiotensin II type 1 receptor gene and plasma level of B- and C-natriuretic peptides in women with essential hypertension who underwent myocardial infarction or cerebral stroke, the role in prognosis and diagnostic

The dissertation is devoted to studying the role of angiotensin II type 1 receptor gene polymorphism, plasma levels of B- and C-natriuretic peptides and changes in intracardiac and systemic hemodynamics in postmenopausal age's women with essential hypertension complicated myocardial infarction or cerebral stroke, residents of the Vinnitsa region, in order to improve evaluation of genetic predisposition to essential hypertension and its vascular complications. 232 postmenopausal age's women (50-65 years), residents of Vinnitca region were investigated. AT1R genotypes were determined by polymerase chain reaction (PCR) after selection of genomic DNA from leucocytes of the venous blood. For determination of BNP, CNP, ET-1 concentrations in blood plasma of the patients the ELISA method was used. The structural and functional indexes of myocardium were examined ultrasonically with eсhoсardiography "Sim-5000 plus". It was established that the inheritance of C allele of angiotensin II type 1 receptor gene was associated with the development of hypertension and myocardial infarction on its background. In women with essential hypertension who underwent myocardial infarction or cerebral stroke inheritance C allele was associated with more severe abnormalities of structural and functional parameters of myocardium than in homozygots of allele A. High plasma levels of BNP, CNP and ET-1 in hypertensive patients were associated with myocardial infarction, cerebral stroke, the diastolic myocardial disfunction, severe left ventricular hypertrophy. The highest plasma levels of these peptides were determined in carriers of allele C. Because CNP and ET-1 are antagonists the CNP/ET-1 coefficient (ratio of CNP to ET-1 plasma levels) was calculated in each investigated group. CNP/ET-1 coefficient is responsible for relationship between vasodelatators and vasoconstrictors. In all patients with EH CNP/ET-1 coefficient was lower than in control group, it means that vasoconstrictors prevail over vasodelatators. In the same time in patients with C allele of AT1R gene CNP/ET-1 coefficient was higher than in patients with AA genotype, which can be observed as result of increasing compensator mechanisms.