[Association of polymorphism 4a/4b and 4b/4b in endothelial nitric oxide synthase gene and markers of endothelial dysfunction in patients with chronic heart failure].

Aim: To examine the association of polymorphism 4a/4b and 4b/4b in endothelial nitric oxide synthase gene (eNOS) with levels of natriuretic peptide type-C, endothelin-1 and vasoregulative endothelial function in patients with chronic heart failure (CHF) depending on the ejection fraction of the left ventricle.

Materials And Methods: The study has included 280 patients with CHF of ischemic etiology and 60 somatically healthy individuals. A comprehensive assessment of the markers of the vascular endothelium function was carried out for all patients (endothelial function coefficient, natriuretic peptide type-C, endothelin-1) in association of polymorphism 4a/4b and 4b/4b gene of eNOS.

Results: Correlations between the ejection fraction of the left ventricle and the levels of the natriuretic peptide-type C and endothelin-1 have been established. Endothelial dysfunction was revealed in all patients with CHF, but patients with 4a/4b gene of eNOS had more pronounced disorders. The association between the levels of biochemical markers of the endothelial dysfunction with polymorphism 4a/4b gene eNOS was also rervealed. The levels of the natriuretic peptide type C and endothelin-1 were higher in subgroups with genotype 4a/4b of gene eNOS both in patients with CHF with a preserved and with a reduced ejection fraction of the left ventricle.

Conclusion: In patients with CHF with preserved and reduced ejection fraction of the left ventricle the association of polymorphism 4a/4b gene eNOS with levels of biochemical markers of endothelial dysfunction and vasoregulative endothelial function was revealed.