Lobach L. Clinico-hemodynamic features of the course of ischemic heart disease, postinfarction cardiosclerosis in patients with polymorphism of the aldosterone synthetase gene CYP11B2

The scientific task of the dissertation was to determine the influence of the aldosterone synthase gene polymorphism on the left ventricular myocardial function in patients with coronary heart disease, PIC and stratification of cardiovascular risk, depending on the variants of the aldosterone synthetase gene polymorphism. Аt the Cardiology Department of Shupyk NMAPE general clinical examination of 378 patients was held. Patients were divided into four groups: 100 patients with postinfarction cardiosclerosis, 78 patients with CAD without myocardial infarction in history, 100 high cardiovascular risk patients (with diabetes, hypertension or dyslipidemia) and 100 healthy patients (absence of cardiovascular disease was confirmed by medical history, ECG, blood pressure measurement and stress-ECG). Genetic testing was performed by polymerase chain reaction in real time at the Institute of Physiology named after AA Bogomolets. Ultrasound of the heart was done for the evaluation of diastolic function for all patients. The statistical analysis of the results was performed using the Microsoft Excel program, the statistical program SPSS (version 23, USA). When analyzing the average levels of low density lipoprotein (LDL) cholesterol statistically significant difference between the group patients postinfarction cardiosclerosis and the group of high-risk patients (2,93 ±1,2 mmol/L vs 63,4±1,2 mmol/l, р=0,01) was demonstrated, indicating a better cholesterol control in group of postinfarction cardiosclerosis, despite the fact that the average cholesterol level did not reach the target. In order to determine the predictive value of the polymorphism of the aldosterone synthetase gene in patients with coronary artery disease, PIC evaluated the distribution of endpoints by constructing the Kaplan-Meier curve over 12 months of follow-up. In the analysis of all end points, statistically significant differences between the Kaplan-Meyer curves were found on the recessive model of inheritance using the statistical criteria of Mantel-Cox (P=0,01), Breslow (P=0,04), Taron-Hier (P=0,02). In the analysis of patients-monozygotes (TT versus СС), the difference in the rates across all endpoints was not statistically significant.