POLYMORPHISM OF GENES RESPONSIBLE FOR NEUROHUMORAL MECHANISMS OF DEVELOPMENT OF CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION IN PERSONS WITH TYPE 2 DIABETES MELLITUS

The search for genetic markers of chronic heart failure (CHF), comorbid with type II diabetes mellitus, is an urgent task. The study aim was to identify genetic polymorphisms associated with impaired neurohumoral regulation in patients with CHF with preserved and low ejection fraction and type II diabetes mellitus. Material and methods. Polymorphisms of genes responsible for neurohumoral mechanisms of CHF development were studied in 167 patients (69.9±10.1 years) with type II diabetes mellitus, hypertension, CHF with preserved or low ejection fraction, and healthy volunteers. Results and discussion. The angiotensin gene, angiotensin-converting enzyme, angiotensin 1 and 2 receptors polymorphisms are not involved in the CHF formation in patients with type II diabetes mellitus. In the control group, rs1403543 GA polymorphism was found in 90.48% of the examined, in patients with CHF with preserved ejection fraction and type II diabetes mellitus, GA and AA variants were found in 20% of cases, in the CHF group with a low ejection fraction AA polymorphism was found in 53.85% of the examined. It is possible they do not participate in the formation of CHF in patients with type II diabetes mellitus, or have a protective effect. The gene GNB: 825 C > T rs5443 polymorphism was detected from 53.33 to 61.9% of the examined in all groups. rs1799998 polymorphism is not associated with the development of CHF. The rs2070744 polymorphism is associated with the development of CHF with a preserved ejection fraction, but not CHF with a low ejection fraction, in patients with type II diabetes mellitus. The gene NOS3: 894 G > T rs1799983 in heterozygous and homozygous variants polymorphism was more common in patients with CHF with preserved ejection fraction (statistically insignificant). Conclusions. CHF with a preserved ejection fraction and CHF with a low ejection fraction in patients with type II diabetes mellitus are associated with different polymorphisms and have different pathogenesis. The gene AGTR2 polymorphism rs1403543 in patients with type II diabetes mellitus and CHF with preserved ejection fraction occurs less frequently than in the control group. The gene GNB polymorphism rs5443 in patients with CHF with a preserved ejection fraction and CHF with a low ejection fraction occurs much less frequently than in the control group. The gene NOS3 polymorphism rs2070744 in patients with CHF with a preserved ejection fraction occurs significantly more often than in the control group and in patients with CHF with a low ejection fraction.