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Aim. To evaluate association of clinical and genetic factors with left ventricle hypertrophy (LVH) in patients with arterial hypertension (HT).

Materials and methods. 672 patients with HT were involved, aged 50,6 y.o. in average, men 67%. Laboratory assays, ECG, echocardiography were performed. Control group included 184 healthy per￾sons. Genotyping with single-nucleotide substitutions of the endothelial NO synthase (eNOS) Glu298Asp gene, the C242T of the NADPH oxidase p22phox subunit and the angiotensin 2 receptor type 1 А1166С gene was carried out using a polymerase chain reaction (PCR) with evaluating of restriction fragments length polymorphism, while with substitutions of the angiotensinogen М235Т, G(-6)A gene allele-specific PCR “in real time” was applied.

Results. LVH was found in 39% of patients. It was more frequent in persons above 50 years old (OR 2,8, р<0,0001), in men (OR 1,43, p=0,035), in HT of degree 2-3 (OR 3,35, р<0,0001), HT duration more than 5 years (OR 2,52, р<0,05), in obesity (OR 1,57, р=0,005) or diabetes (OR 3,33, р<0,0001) presence. At genetic factors evaluation decrease of LVH risk was revealed in persons with the MM polymorphism of the angiotensinogen М235Т gene (OR 0,506, р=0,0187). Association of the MM genotype with LVH risk lowering was more obvious at the young age (OR 0,31, р=0,018). The A allele of the eNOS gene Glu298Asp polymorphism increased risk of LVH development when HT was diagnosed in the young age (OR 1,98, р=0,037) and in women up to 50 years old (OR 2,34, р=0,027). The T allele of the p22phox NADPH oxidase gene С242Т polymorphism correlated with LVH risk reduction in HT patients up to 50 years old (OR 0,6, p=0,01), the C allele – with increase of it (OR 1,66, р=0,01), this influence was more noticeable in women up to 50 years old (T allele – OR 0,21; C allele – OR 4,57, p=0,001).

Conclusion. Hypertensive LVH correlates with age, male gender, HT degree and duration, obesity and diabetes mellitus. Genetic factors were less associated with LVH.

About the Authors

T. Yu. Kuznetsova
Petrozavodsk State University, Chair of faculty therapy
Russian Federation
Prosp. Lenina 33, Petrozavodsk, 185000

D. V. Gavrilov
Hospital of urgent medicine
Russian Federation
Ul. Kirova 40, Petrozavodsk, 185000

L. M. Samohodskaya
Moscow State University named after M.V. Lomonosov
Russian Federation
Lomonosovskiy prosp. 31-5, Moscow, 119192

D. V. Rebrikov
Research and Production Company “DNK-Technologya”
Russian Federation
Kashirskoye shosse 24-2, Moscow, 115478

S. A. Morozova
Research and Production Company “DNK-Technologya”
Russian Federation
Kashirskoye shosse 24-2, Moscow, 115478

P. I. Makarevich
Moscow State University named after M.V. Lomonosov
Russian Federation
Lomonosovskiy prosp. 31-5, Moscow, 119192

A. V. Kolotvin
Moscow State University named after M.V. Lomonosov
Russian Federation
Lomonosovskiy prosp. 31-5, Moscow, 119192

A. B. Balatsky
Russian Cardiology Research and Production Complex
Russian Federation
Tretya Cherepkovskaya ul. 15a, Moscow, 121552

A. Yu. Postnov
Russian Cardiology Research and Production Complex
Russian Federation
Tretya Cherepkovskaya ul. 15a, Moscow, 121552

S. A. Boitsov
Russian Cardiology Research and Production Complex
Russian Federation
Tretya Cherepkovskaya ul. 15a, Moscow, 121552


1. LevyD., Salomon M., D'Agostino R.B. et al. Prognostic implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy. Circulation 1994;90(4):1786–93.

2. Koren M.J., Devereux R.B., Casale P.N. et al. Relation of left ventricular mass and geometry on morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 1991;114(5):345–52.

3. Levy D., Garrison R.J., Savage D.D. et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990;322(22):1561–6.

4. Diagnostics and treatment of arterial hypertension. Guidelines of Russian Society on hypertension and Society of Cardiology of the Russian Federation. Cardiovascular therapy and prevention 2008;7(6) Supplement 2:3-32 (in Russian). / Диагностика и лечение артериальной гипертензии. Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов. Кардиоваскулярная терапия и профилактика 2008;7(6) Приложение 2:3-32.

5. Gavrilov D.V., Gusev A.V., Kuznetsova T.U., Dudanov I.P. Automatic formation of arterial hypertension diagnosis at hospital working in the integrated medical information system. Medical academic journal 2005;5(3) Supplement 7:64-7 (in Russian). / Гаврилов Д.В., Гусев А.В., Кузнецова Т.Ю., Дуданов И.П. Автоматическое формирование диагноза гипертонической болезни в условиях работы учреждения в комплексной медицинской информационной системе. Медицинский академический журнал 2005;5(3) Приложение 7:64-7.

6. Frigo G., Bertolo O., Roman E. et al. Relationship of left ventricular mass with clinic blood pressure measured over a six month period vs. ambulatory blood pressure (abstract). J Hypertens 2000;18(suppl 2):S44.

7. Grandi A.M., Zanzi P., Piantanida E. et al. Obesity and left ventricular diastolic function: noninvasive study in normotensives and newly diagnosed never-treated hypertensives. Int J Obes Relat Metab Disord 2000;24(8):954–8.

8. Smalcelj A., Puljević D., Buljević B. et al. Left ventricular hypertrophy in obese hypertensives: is it really eccentric? (An echocardiographic study). Coll Antropol 2000;24(1):167–83.

9. Kobalava Z.D., Kotovskaya U.V. Arterial hypertension: keys to diagnostics and treatment. M.: Forte; 2007 (in Russian). / Кобалава Ж.Д., Котовская Ю.В. Артериальная гипертония: ключи к диагностике и лечению. М.: Фортэ; 2007.

10. Bloomgarden Z.T.Diabetes and hypertension.Diabetes Care 2001;24(9):1679- 84.

11. Brazznik V.A., Zateishikov D.A., Sidorenko B.A. Heriditary factors and left ventricle hypertension. Cardiology 2003;43(1):78-88 (in Russian). / Бражник В.А., Затейщиков Д.А., Сидоренко Б.А. Наследственные факторы и гипертрофия левого желудочка. Кардиология 2003;43(1):78–88.

12. Boitsov S.A., Turdialieva S.A., Karpenko M.A. et al. Hemodynamic and metabolic characteristics in relation with structure polymorphism ofthe ACE genes and genes of the angiotensin 2 first type receptors in women of child-bearing age with hypertension of the first degree. Cardiology 2003;43(7):65-9 (in Russian). / Бойцов С.А., Турдиалиева С.А., Карпенко М.А., др. Особенности гемодинамики, метаболизма и структурный полиморфизм генов АПФ и рецепторов первого типа ангиотензина 2 у женщин детородного возраста при артериальной гипертензии первой степени. Кардиология 2003;43(7):65–9.

13. Shliahto E.V., Conradi A.O. Role of genetic factors in cardiovascular system remodeling at hypertension. Arterial hypertension 2002; 8(3):107-14 (in Russian). / Шляхто Е.В., Конради, А.О. Роль генетических факторов в ремоделировании сердечно-сосудистой системы при гипертонической болезни. Артериальная гипертензия 2002; 8(3):107–14.

14. Kobalava Z.D., Kotovskaya U.V., Chistiakov D.A. et al. Clinic and genetic determinants of LV hypertrophy in patients with essential hypertension. Cardiology 2001;41(7):39-44 (in Russian). / Кобалава Ж.Д., Котовская Ю.В., Чистяков Д.А., др. Клинико-генетические детерминанты гипертрофии ЛЖ у больных эссенциальной гипертензией. Кардиология 2001;41(7):39–44.

15. Dzida G., Sobstyl J., Puzniak A. et al. Polymorphisms of angiotensin-converting enzyme and angiotensin II receptor type 1 genes in essential hypertension in a Polish population. Med Sci Monit 2001;7(6):1236–41.

16. Corvol P., Persu A., Gimenez-Roqueplo A.P. et al. Seven lessons from two candidate genes in human essential hypertension: angiotensinogen and epithelial sodium channel. Hypertension 1999;33(6):1324–31.

17. Kunz R., Kreutz R., Beige J. et al. Association between the angiotensinogen 235Tvariant and essential hypertension in whites: a systematic review and methodological appraisal. Hypertension 1997;30(6):1331–7

18. Staessen J.A., Kuznetsova T., Wang J.G. et al. M235T angiotensinogen gene polymorphism and cardiovascular renal risk. J Hypertens 1999;17(1):9–17.

19. Karjalainen J., Kujala U.M., Stolt A. et al. Angiotensinogen gene M235T poly￾morphism predicts left ventricular hypertrophy in endurance athletes. J Am Coll Cardiol 1999;34(2):494–9.

20. Olcay A., Nişanci Y., Ekmekçi C.G. et al. Angiotensinogen M235T polymorphism and left ventricular indices in treated hypertensive patients with normal coronary arteries. Anadolu Kardiyol Derg 2007;7(3):257–61.

21. Wang A.Y., Chan J.C., Wang M. et al. Cardiac hypertrophy and remodeling in relation to ACE and angiotensinogen genes genotypes in Chinese dialysis patients. Kidney Int 2003;63(5):1899–907.

22. Province M.A., Boerwinkle E., Chakravart A. et al. Lack of association of the angiotensinogen-6 polymorphism with blood pressure levels in the comprehensive NHLBI Family Blood Pressure Program. J Hypertens 2000;18(7):867–76.

23. Kuznetsova T., Staessen J.A., Reineke T. et al. Context-dependency of the relation between left ventricular mass and AGT gene variants. J Hum Hypertens 2005;19(2):155–63.

24. Patel D.A., Li S., Chen W. et al. G-6A polymorphism of the angiotensinogen gene and its association with left ventricular mass in asymptomatic young adults from a biethnic community: the Bogalusa Heart Study. Am J Hypertens 2005;18(11):1437–41.

25. Lapu-Bula R., Quarshie A., Lyn D. et al. The 894T allele of endothelial nitric oxide synthase gene is related to left ventricular mass inAfricanAmericans with highnormal blood pressure. J Natl Med Assoc 2005;97(2):197–205.

26. Czarnecka D., Kawecka-Jaszcz K., Stolarz K. et al. Ambulatory blood pressure, left ventricular mass and vascular phenotypes in relation to the endothelial nitric oxide synthase gene Glu298Asp and intron 4 polymorphisms in a population-based family study. J Hum Hypertens 2005;19(5):413–20.

27. Karvonen J., Kauma H., Kervinen K. et al. Endothelial nitric oxide synthase gene Glu298Asp polymorphism and blood pressure, left ventricular mass and carotid artery atherosclerosis in a population-based cohort. J Intern Med 2002;251(2):102–10.

28. Zhu H., Wang X., Dong Y. et al. Influence of the eNOS gene on development of blood pressure and left ventricular mass: longitudinalfindings in multiethnic youth. Pharmacogenet Genomics 2005;15(9):669–75.

For citation:

Kuznetsova T.Yu., Gavrilov D.V., Samohodskaya L.M., Rebrikov D.V., Morozova S.A., Makarevich P.I., Kolotvin A.V., Balatsky A.B., Postnov A.Yu., Boitsov S.A. ASSOCIATION OF CLINICAL AND GENETIC FACTORS WITH LEFT VENTRICLE HYPERTROPHY IN ARTERIAL HYPERTENSION. Rational Pharmacotherapy in Cardiology. 2010;6(3):294-305.

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