The purpose of the study was to determine the levels of angiotensin II depending on polymorphisms A1166C of the gen AGTR1, T174M of the gen AGT among the patients with paroxysmal atrial fibrillation with the coronary heart disease and hypertension. Material and methods. A prospective, open-ended, comparative study was conducted on the basis of the City Hospital No. 10 in Zaporizhzhya. To participate in the study, patients signed the form "Voluntary informed consent to participate in the study". Patients were sampled from 2014 to 2019. The results of the study are based on data from a comprehensive examination and dynamic observation of 186 patients with paroxysmal atrial fibrillation, 78 of whom were from countryside, 98 were from city Zaporizhzhya. Verification of the diagnosis of paroxysmal form of atrial fibrillation was performed in accordance with the recommendations for the treatment of atrial fibrillation of the European Society of Cardiology in 2016. The presence of atrial fibrillation was determined by recording the electrocardiogram changes in the patient during the examination. The division of patients into groups was performed after establishing the compliance of patients with the inclusion and exclusion criteria of the study depending on the place of residence. Nearly healthy 31 volunteers were examined on an outpatient setting on the basis of City Hospital № 10. All of the subjects were evaluated for gene polymorphism, angiotensin II level. The results and discussion. The obtained results are the following: The surveyed individuals had lower level of angiotensin II in the homozygote (CC) group in the allele C polymorphism A1166C of the gene AGTR1 compared with the homozygotes (AA) in the allele A and heterozygotes (AC). The level of angiotensin II did not differ significantly in the groups of T174M polymorphism of the AGT gene among patients with coronary heart disease with hypertension and paroxysmal atrial fibrillation. There was no significant difference in angiotensin II levels among groups of patients with coronary heart disease with hypertension and paroxysmal atrial fibrillation from urban and rural areas, and group of healthy people. Conclusion. The results of the study proved the necessity of the further research to determine the dependence of angiotensin II on the variation of gene polymorphisms. This can help in stratification of the risk of recurrence of atrial fibrillation, creating a set of treatment and prevention measures based on the individual characteristics of the patient, which in turn can form the basis of personalized medicine. Further in-depth research in this direction is needed to develop a personalized approach to drug selection that can improve the prognosis in patients with paroxysmal atrial fibrillation, which will provide targeted correction of pathogenetic processes taking into account the genotypic characteristics of the patient.
Keywords: angiotensin II, polymorphism, gene, atrial fibrillation, coronary heart disease, hypertension
Full text: PDF (Ukr) 201K