INFLUENCE OF THE POLYMORPHISM OF THE RENIN-ANGIOTENSIN SYSTEM GENES ON THE CARDIAC ARRHYTHMIAS IN CHILDREN WITH HYPERTROPHIC CARDIOMYOPATHY

Hypertrophic cardiomyopathy (HCMP) is a genetically determined myocardial disease, characterized by massive hypertrophy of the myocardium of the left and/or (rarely) the right ventricle, often associated with obstruction of the left ventricular outflow tract and diastolic dysfunction. The course of disease can be complicated by development of various cardiac arrhythmias.  It was reported that severity of HCMP course depends at certain degree on polymorphism of candidate genes, including genes of the renin angiotensin system (RAS). Influence of RAS genes polymorphism on the frequency and character of cardiac arrhythmias in childhood is almost not studied. Aim: to determine the influence of RAS genes polymorphism on the prevalence and structure of cardiac arrhythmias in children with HCMP. Patients and methods: analysis of influence of RAS genes polymorphism on the prevalence and structure of cardiac arrhythmias was performed in 32 children with HCMP. All the patients were carried out ECG, cardiac ultrasound and ECG Holter monitoring. Polymorphism of the RAS genes (renin gene (REN) G83A, angiotensinogen gene (AGT) M235T, angiotensin-converting enzyme gene (ACE) I/D, angiotensin II receptor type 1 gene (AGTR1) A1166C). Results: in patients with HCMP was established a higher frequency of TT-genotype and T-alleles of angiotensinogen gene than in comparison group. In homozygous patients with T-allele of angiotensinogen gene ventricular arrhythmia was found reliably more often than in patients with MT- and MM-genotypes, which suggested that M235T polymorphism of angiotensinogen gene influenced on intensity of ventricular arrhythmias in children with HCMP. Conclusions: in children with HCMP and cardiac arrhythmias analysis of M235T polymorphism of angiotensinogen gene can be used as an additional criterion for revealing of patients with high risk of arrhythmic complications and for development of preventative measures.

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