The objective: To determine the prevalence and the effect of combined haplotypes of β1- and β2-adrenergic receptor genes on the course of heart failure.
Materials and methods. 200 patients with heart failure were included to study. The clinical course of the disease was detected. The polymorphisms Ser49Gly and Gly389Arg of the β1-adrenoreceptor gene and polymorphism Gln27Glu of the β2-adrenoreceptor gene were studied. The material for molecular genetic studies were peripheral blood leukocytes of patients. The genomic DNA was isolated by the Wolfgang method. The primerine sequences were used for the polymerase chain reaction.
Results and discussion. The most unfavorable combined haplotypes of β1- and β2-adrenergic receptor genes for cardiac insufficiency are Ser49Ser / Gly389Gly-Gln27Gln and Ser49Ser / Gly389Gly-Glu27Gln. These patients have a negative dynamics of the left ventricular ejection fraction and the left atrium diameter during the follow-up period, a poor chronotropic response to bisoprolol use, a greater incidence of atrial fibrillation, a higher hospitalization due to decompensation of the heart failure. Along with this, these patients are the best responders to the use of carvedilol. Given these circumstances, in patients with heart failure who have combined haplotypes of the Ser49Ser / Gly389Gly-Gln27Gln and Ser49Ser / Gly389Gly-Glu27Gln polymorphisms, it is possible that if this type of β1- and β2-adrenergic receptor gene polymorphisms is detected, the administration of carvedilol and / or amiodarone (with a preventive anti-arrhythmic goal).
Conclusions. The combinations of haplotypes of β1- and β2-adrenoreceptor genes Ser49Ser / Gly389Gly / Gln27Gln and Ser49Ser / Gly389Gly / Glu27Gln are occured respectively in 2 and 4% of patients with heart failure. These patients have a negative dynamics of the left ventricular ejection fraction and the left atrium diameter, a high incidence of atrial fibrillation, a large hospitalizations due to decompensation of the disease, a low chronotropic response to the use of bis-prolol. The carvedilol is more effective than bisoprolol in reducing heart rate in these patients.
Key words: heart failure, clinical course, polymorphism, gene, β1-adrenergic receptors, β2-adrenoreceptors.
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