evrazkarЕвразийский Кардиологический ЖурналEurasian heart journal2225-16852305-0748Евразийская ассоциация кардиологов10.38109/2225-1685-2014-2-63-70evrazkar-5587Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSПОЛИМОРФИЗМ ГЕНОВ АНГИОТЕНЗИНПРЕВРАЩАЮЩЕГО ФЕРМЕНТА, КЛИНИЧЕСКОЕ ТЕЧЕНИЕ И СТРУКТУРНОФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ СЕРДЦА У ЛИЦ УЗБЕКСКОЙ НАЦИОНАЛЬНОСТИ, СТРАДАЮЩИХ ДИЛАТАЦИОННОЙ КАРДИОМИОПАТИЕЙANGIOTENSIN-CONVERTING ENZYME GENE POLYMORPHISM., THE CLINICAL COURSE AND THE STRUCTURAL AND FUNCTIONAL STATE OF THE HEART AT THE UZBEK PATIENTS WITH DILATED CARDIOMYOPATHYКурбановРафшан ДавлетовичKurbanovR. D.noemail@neicon.ruКурбановНурали АбдурахмановичKurbanovN. A.noemail@neicon.ruАбдуллаевТимур АтаназаровичAbdullayevT. A.noemail@neicon.ruРеспубликанский Специализированный Центр Кардиологии МЗ РУзРоссияRepublican Specialized Center of Cardiology Ministry of Health of UzbekistanRussian Federation201430062014026370Copyright © Курбанов Р.Д., Курбанов Н.А., Абдуллаев Т.А., 20142014Курбанов Р.Д., Курбанов Н.А., Абдуллаев Т.А.Kurbanov R.D., Kurbanov N.A., Abdullayev T.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.heartj.asia/jour/article/view/5587

Актуальность. Изучение полиморфизма генов ангиотензинпревращающего фермента (АПФ) и их вклад в развитие и течение ДКМП, а также возможность ранней диагностики и дифференцированной фармакотерапии на ранних и развернутых стадиях этого заболевания является новым перспективным направлением медицинской генетики в целом, и кардиологии в частности. Цель. Изучение полиморфизма генов АПФ у больных ДКМП в узбекской популяции, особенностей клинического течения и процессов ремоделирования сердца в зависимости от генотипа, а также оценка эффективности лизиноприла у этих больных. Материал и методы. Было обследовано 102 больных ДКМП узбекской национальности с ХСН II-IV ФК по NYHA. Помимо оценки общеклинического статуса с использованием теста шестиминутной ходьбы, ШОКС (в модификации Мареева), были проведены: ЭКГ в 12 стандартных отведениях, ЭхоКГ, ХМЭКГ, рентгенкардиометрия. Данные анализировались в зависимости от выявленного генотипа. Результаты. Впервые был изучен I/D полиморфизма гена АПФ у больных ДКМП узбекской национальности. Показаны отличия клинических и инструментальных данных в зависимости от генотипа, выявлены неблагоприятные типы наследования генов. Отмечена высокая эффективность применения лизиноприла у категорий больных в зависимости от полиморфизма гена АПФ.

Background. The study of genes polymorphism of angiotensinconverting enzyme (ACE) and their contribution to development and clinical course of dilated cardiomyopathy (DCM), and the possibility of early diagnostics and differentiated pharmacotherapy in early and advanced stages of the disease, is a promising new area of medical genetics and cardiology research. The aim. To study the genes polymorphism of angiotensinconverting enzyme (ACE) at DCM patients in the Uzbek population, to reveal the feature of heart remodeling depending on a genotype, and also an estimation of Lisinopril efficiency at these patients. Material and methods. It has been surveyed 102 DCM patients of the Uzbek nationality, with II-IV classes by NYHA. Besides an estimation of the clinical status (test of six-minute walking, clinical status estimation score (in Mareev modification) it has been spent 12-led ECG, EchoCG, Holter ECG, rentgenkardiometriya. These data were analyzed depending on the revealed genotype. Results. For the first time we have studied the genes polymorphism at Uzbek DCM patients. It has been showed feature of clinical and instrumental data depending on genotype, and also revealed unfavorable types of gene inheritance. It has been noted a high efficiency of Lisinopril application at DCM patients depending on the ACE- genes polymorphism.

полиморфизм генов АПФдилатационная кардиомиопатияузбекская национальностьлизиноприлACE gene polymorphismdilated cardiomyopathythe Uzbek nationalitylisinoprilReferencesShelling P., Fisher H., Ganten D. Angiotensin and cell growth: a link to cardiovascular hypertrophy. Br Heart J. 1993; 49: 568-573.Shelling P., Fisher H., Ganten D. Angiotensin and cell growth: a link to cardiovascular hypertrophy. Br Heart J. 1993; 49: 568-573.Danser A., Schalekamp M., Bax W.A. et al. Effect of deletion/ insertion polymorphism. Circulation. 1995; 92: 1387-1388.Danser A., Schalekamp M., Bax W.A. et al. Effect of deletion/ insertion polymorphism. Circulation. 1995; 92: 1387-1388.Мустафина О.Е., Туктарова И.А., Бикмеева Т.Р. Исследование инсерционно-делеционного полиморфизма гена ангиотензин-превращающего фермента в популяциях Волго-Уральского региона. Ж. Генетика. 2001; 37(2): 1-5.Мустафина О.Е., Туктарова И.А., Бикмеева Т.Р. Исследование инсерционно-делеционного полиморфизма гена ангиотензин-превращающего фермента в популяциях Волго-Уральского региона. Ж. Генетика. 2001; 37(2): 1-5.Lee E.J. Population genetics of the angiotensin-converting enzyme in Chinese. Brit J Clin Pharmacol. 1994; 37: 212-214.Lee E.J. Population genetics of the angiotensin-converting enzyme in Chinese. Brit J Clin Pharmacol. 1994; 37: 212-214.Беленков Ю.Н., Мареев В.Ю. Принципы рационального лечения сердечной недостаточности. - М., 2000.-266с.Беленков Ю.Н., Мареев В.Ю. Принципы рационального лечения сердечной недостаточности. - М., 2000.-266с.Guyatt G.H., Sullivan M.J.,Tompson P.J. et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J.1985; 132 (8): 919-923Guyatt G.H., Sullivan M.J.,Tompson P.J. et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J.1985; 132 (8): 919-923Richardson P., McKenna W., Bristow M. et al. Report of the 1995 World Organization. International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation. 1996; 93: 841-842.Richardson P., McKenna W., Bristow M. et al. Report of the 1995 World Organization. International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies. Circulation. 1996; 93: 841-842.Raynolds M.V., Bristow M.R., Bush E.W. et al. Angiotensinconverting enzyme DD genotype in patients with ischaemic or idiopathic dilated cardiomyopathy. Lancet. 1993; 342: 10731075.Raynolds M.V., Bristow M.R., Bush E.W. et al. Angiotensinconverting enzyme DD genotype in patients with ischaemic or idiopathic dilated cardiomyopathy. Lancet. 1993; 342: 10731075.Montgomery H.E., Keeling P.J., Goldman J.H., Humphries S.E. at al. Lask of association between the insertion/deletion polymorphism of the angiotensin-converting enzyme gene and idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 1995; 25: 1627-1631.Montgomery H.E., Keeling P.J., Goldman J.H., Humphries S.E. at al. Lask of association between the insertion/deletion polymorphism of the angiotensin-converting enzyme gene and idiopathic dilated cardiomyopathy. J Am Coll Cardiol. 1995; 25: 1627-1631.Brandt-Pohlmann M., Pohle K., Beyer-Finkler E. et al. Polymorphism of angiotensin-converting enzyme gene in patients with idiopathic dilated cardiomyopathy. XIX Congress of the European Society of Cardiology. August 24-28, 1997-Stokholm, Sweden.Brandt-Pohlmann M., Pohle K., Beyer-Finkler E. et al. Polymorphism of angiotensin-converting enzyme gene in patients with idiopathic dilated cardiomyopathy. XIX Congress of the European Society of Cardiology. August 24-28, 1997-Stokholm, Sweden.Iwai N., Ohmichi N., Nakamura Y. еt al. DD genotype of the angiotensin-converting enzyme gene is a risk factor for left ventricular hypertrophy. Circulation. 1994; 90: 2622-2628.Iwai N., Ohmichi N., Nakamura Y. еt al. DD genotype of the angiotensin-converting enzyme gene is a risk factor for left ventricular hypertrophy. Circulation. 1994; 90: 2622-2628.Pontermoni M., Sofia A., Tirotta A. et al. The deletion polymorphism of the angiotensin-converting enzyme gene is associated with target organ damage in essential hypertension. J Am. Soc Nephrol. 1996; 7: 2550-2558.Pontermoni M., Sofia A., Tirotta A. et al. The deletion polymorphism of the angiotensin-converting enzyme gene is associated with target organ damage in essential hypertension. J Am. Soc Nephrol. 1996; 7: 2550-2558.Johnson D.B., Foster R.E., Kirk K. et al. Angiotensin-Converting Enzyme Genotype Does Not Influence Myocardial Hypertrophy After Acute Myocardial Infarction. In: Congress of the European Society of Cardiology, 21-th: Abstract. Stockholm 1997; 970.Johnson D.B., Foster R.E., Kirk K. et al. Angiotensin-Converting Enzyme Genotype Does Not Influence Myocardial Hypertrophy After Acute Myocardial Infarction. In: Congress of the European Society of Cardiology, 21-th: Abstract. Stockholm 1997; 970.Skudicky D., Norton G., Candy G. et al. DD genotype of the angiotensin-converting enzyme gene in associated with a greater improvement of left ventricular function in patients with idiopathic dilated cardiomyopathy treated with ACE-inhibitors. In: Congress of the European Society of Cardiology, 21-th: Abstract. Stockholm 1997; 1677.Skudicky D., Norton G., Candy G. et al. DD genotype of the angiotensin-converting enzyme gene in associated with a greater improvement of left ventricular function in patients with idiopathic dilated cardiomyopathy treated with ACE-inhibitors. In: Congress of the European Society of Cardiology, 21-th: Abstract. Stockholm 1997; 1677.Andersson B., Sylven C. The DD genotype of the angiotensinconverting enzyme gene is associated with increased mortality in idiopathic heart failure. J Am Coll Cardiol 1996; 28: 162-167.Andersson B., Sylven C. The DD genotype of the angiotensinconverting enzyme gene is associated with increased mortality in idiopathic heart failure. J Am Coll Cardiol 1996; 28: 162-167.Fazio S., Sabatini D., Capaldo B. et al. A preliminary study of growth hormone in the treatment of dilated cardiomyopathy. N Engl J Med. 1996; 334-809.Fazio S., Sabatini D., Capaldo B. et al. A preliminary study of growth hormone in the treatment of dilated cardiomyopathy. N Engl J Med. 1996; 334-809.Rigat B., Hubert C., Alhenc-Gelas F. et al. An insertion/deletion polymorphism in the angiotensin-I-converting enzyme gene accounting for half the variance of serum enzyme levels. J Clin Invest 1990; 86: 1343-1346.Rigat B., Hubert C., Alhenc-Gelas F. et al. An insertion/deletion polymorphism in the angiotensin-I-converting enzyme gene accounting for half the variance of serum enzyme levels. J Clin Invest 1990; 86: 1343-1346.Moe G.W., Stewart D.J. Role of the renin-angiotensin system in the pathophysiology of the heart failure. Medicographia. 1997; 19: 18-22.Moe G.W., Stewart D.J. Role of the renin-angiotensin system in the pathophysiology of the heart failure. Medicographia. 1997; 19: 18-22.Ribichini F., Steffening G., Dellavalle A. et al. Plasma activity and insertion/deletion polymorphism of angiotensin I-converting enzyme gene. A major risk factor and a market of risk for coronary stent restenosis. Circulation. 1998; 97: 147-154.Ribichini F., Steffening G., Dellavalle A. et al. Plasma activity and insertion/deletion polymorphism of angiotensin I-converting enzyme gene. A major risk factor and a market of risk for coronary stent restenosis. Circulation. 1998; 97: 147-154.Pfeffer J.M. Pfeffer M.A., Braunwald E. Influence of chronic captopril therapy on the infarcted left ventricle of the rats. Circ. Res. 1985; 57: 84-95Pfeffer J.M. Pfeffer M.A., Braunwald E. Influence of chronic captopril therapy on the infarcted left ventricle of the rats. Circ. Res. 1985; 57: 84-95Dzau V. Tissue renin-angiotensin system in myocardial hypertrophy and failure. Arch Intern Med 1993; 153: 937-942.Dzau V. Tissue renin-angiotensin system in myocardial hypertrophy and failure. Arch Intern Med 1993; 153: 937-942.Bell D.M., Rutledge D.R., Pepine C.J. Association of the Insertion/ Deletion Polymorphism of the Angiotensin Converting Enzyme Gene and Angiotensin Converting Enzyme Inhibitor Cough in Patients with Congestive Heart Failure. In: Congress of the European Society of Cardiology, 21-th: Abstract. Stockholm 1997; 976.Bell D.M., Rutledge D.R., Pepine C.J. Association of the Insertion/ Deletion Polymorphism of the Angiotensin Converting Enzyme Gene and Angiotensin Converting Enzyme Inhibitor Cough in Patients with Congestive Heart Failure. In: Congress of the European Society of Cardiology, 21-th: Abstract. Stockholm 1997; 976.Терещенко C.H., Джаиани Н.А., Моисеев В.С. Генетические аспекты хронической сердечной недостаточности. Тер. Арх. 2000; 4: 75-77.Терещенко C.H., Джаиани Н.А., Моисеев В.С. Генетические аспекты хронической сердечной недостаточности. Тер. Арх. 2000; 4: 75-77.

The authors declare that there are no conflicts of interest present.