The BNP gene polymorphism in women and plasma peptide levels for the screening diagnostics of chronic heart failure in essential hypertension

Abstract

Essential hypertension (EH) and its complication, a chronic heart failure (CHF), are one of the most common pathological tandems in practical cardiology. Link edetiologically and pathogenetically, they share a common path of progression, manifested by structural, functional, and humoral disturbances in cardiovascular homeostasis. The mainstructural changes are an increase in the mass, volume and shape of the left ventricle(LV) due to hypertrophy of cardiomyocytes, hypertrophy and hyperplasia of the interstitium and endothelial cells. Left ventricular hypertrophy is a clear clinical marker of EH progression and deepening of pathological processes in the cardiovascular system. In recent years, a member of the family of natriuretic peptides, brain natriuretic peptide (BNP), has taken the place of one of the biomarkers of myocardial and vascular remodeling processes, most often used in practical medicine; it is also positioned as a humoral antagonist of the activity of renin-angiotensin-aldosterone system(RAAS), which is the leading pathogenetic link in most cases of hypertensive cascade and CHF. However, it is generally known that plasma levels of the peptide depend on numerous factors: the presence of certain cardiovascular pathology, sex, age, comorbidity, and genetic background. This studyaims to supplement the data on the use of BNP as a signaling indicator of changes in myocardial structure and function and calculate the screening threshold levels of peptide in uncomplicated and complicated EH in postmenopausal women with polymorphic variants of the BNP gene. 180 women aged 40-64 living in the Podilliaregion of Ukraine were examined: 67 women without signs of cardiovascular pathology, who were included in the control group, 62 women with uncomplicated EH with LVH,and 51 women with EH complicated by CHF. All the patients were examined according to a standardized plan: general clinical, instrumental, and laboratory examination was conducted. The genotyping of the BNP gene was performed using the polymerase chain reaction. Plasma concentrations of natriuretic peptide were determined by enzymelinked immunosorbent assay. It was revealed that the frequency of carrying the T381C genotype and the C allele significantly prevails among the polymorphic variants of the BNP gene in women 40-65 years of age. The highest level of plasma BNP concentration, which was 193,27 ± 2,98 pg/ml, was determined in women with EH complicated by CHF.In addition, carrying the C alleleof the BNP gene is significantly associated with higher levels of peptide in the blood plasma of women in all the examined groups. In women 40-65 years of age with EH, the value of BMI is inversely correlated with the level of BNP in blood plasma.