The aim: To improve diagnosis of essential hypertension with left ventricular hypertrophy and chronic heart failure in men citizens of Podillya region in Ukraine by determining the plasma levels of cardiotrophin-1 in patients with different CT-1 gene variants. Materials and methods: A total of 70 men with no signs of cardiovascular disease and 100 patients with essential hypertension were examined. Among those, 50 participants had hypertension and left ventricular hypertrophy. Other 50 patients had hypertension complicated by chronic heart failure. Results: It was established that in patients with essential hypertension the frequency of the pool of genotypes GA + AA is higher than the genotype GG (p <0.05). Plasma CT-1 levels ≥ 122,895 pg / ml can be used for early diagnosis left ventricular hypertrophy, and the cut-off level is ≥ 303.81 pg / ml (sensitivity 85.7%, specificity 92%) for screening diagnosis of essential hypertension complications in the form of chronic heart failure. Conclusions: In patients with essential hypertension of varying severity, the GA+АА genotypes of CT-1 gene was found to be dominant. They had higher levels of plasma concentration CT-1. The threshold levels of CT-1 for screening diagnosis of essential hypertension with hypertrophy and chronic heart failure in males (who were residents of the Podillya region of Ukraine) were evaluated.

Purpose of the work is to analyze the diagnostic and predictive value of Cardiotrophin-1 in patients with essential hypertension and chronic heart failure. The analysis is based on a review of articles and research for 2013-2018, using the PubMed databases, eLIBRARY.RU, Web of Science. In its prevalence, essential hypertension is one of the leaders among cardiovascular diseases. In Ukraine, as in the rest of the world, progressive growth in the number of essential hypertension complications is observed annually. One of the most common complications is chronic heart failure. The frequency of hospitalization and fatal cases of chronic heart failure worldwide remains high, so the search for specific markers that will help to assess the cardiovascular risk of patients with chronic heart failure and the effectiveness of treatment is becoming increasingly relevant. This article presents data that may indicate the use of Cardiotrophin-1 as a marker for early diagnosis of essential hypertension and its complications. Cardiotrophin-1 is a protein with a molecular weight of 21.5 kDa, a representative of the interleukin 6 superfamily, capable of inducing hypertrophy and hyperplasia of cardiomyocytes both in vitro and in vivo.

Annotation. The aim of the study was to improve the diagnosis of myocardial diastolic function in men with essential hypertension and chronic heart failure with different variants of the cardiotrophin-1 gene. 100 people aged 40–60 were examined: 50 men with asymptomatic essential hypertension and 50 men with essential hypertension complicated by chronic heart failure. Genotyping of the cardiotrophin-1 gene was performed by polymerase chain reaction. Determination of the concentration of cardiotrophin-1 was performed by enzyme-linked immunosorbent assay. Structural and functional parameters of the myocardium were evaluated using ultrasound of the heart. Mathematical processing of the material was performed on a personal computer using the standard statistical package SPSS 10. It was found that in persons with essential hypertension and chronic heart failure, carriers of the GA + AA variant of the cardiotrophin-1 gene (rs8046707) have significantly higher plasma peptide levels with diastolic dysfunction (p <0.05).

Annotation. According to multiple studies hypertension (AH) is a multifactorial disease. It is recognized that one of the key mechanisms of persistent increase in blood pressure (BP) is the imbalance between vasoconstriction and vasodilation and endothelial dysfunction (ED) is one of the leading links in the pathogenesis of AH. The consequence of ED is a persistent vasoconstrictor reaction which results in myocardial remodeling in the form of left ventricular hypertrophy (LVH) and the subsequent development of congestive heart failure (CHF). One of the most important representatives of the group of vasoconstrictor peptides is endothelin-1 (ET-1). It has been previously shown that the polymorphism of the gene encoding it (Lys198Asn) is associated with fluctuations in ET-1 plasma concentration. In this regard, the corresponding changes in plasma levels of one of the most powerful vasodilators – C-natriuretic peptide (CNP) – remain poorly understood. CNP is a direct antagonist of ET-1 which increases in the blood in AH and can be used as a screening method to identify patients with high BP. The aim of the study – improving the detection of men with AH who has persistent long-term elevations in BP by using the plasma level of CNP and taking into account the carrier of polymorphic variants of the ET-1 gene. The study involved 191 men aged 40-60 years: 79 men were from control group, 62 patients with AH and LVH and 50 patients with AH complicated by CHF II-III classes for NYHA. Enzyme-linked immunosorbent assay was used to determine the plasma concentration of CNP. Genotyping of the ET-1 gene was performed using the polymerase chain reaction. Mathematical processing was performed on a personal computer using the standard statistical package STATISTICA 6.0. It is established that plasma CNP levels in men with AH and LVH (5.21±0.11) pmol/ml and in patients with AH and CHF (5.22±0.13) pmol/ml are significantly higher than in control patients (2.35±0.06) pmol/ml (p<0.0001) however did not differ in patients with AH from different groups. The obtained results allowed to calculate the limit level of CNP which is ≥3.37 pmol/ml and can be used for screening detection of males with persistently elevated BP in the survey of large populations. It was found that in patients with AH as in the control group the Lys/Lys genotype and the Lys allele of the ET-1 gene predominate. There was no significant difference in the frequency of ET-1 gene between groups (p>0.05). It should be noted that in patients with AH carrying all polymorphic variants of the ET-1 gene the level of CNP in blood was also significantly higher than in the control group, however in carriers of the Asn allele plasma level of CNP is higher than in individuals with the Lys/Lys genotype in all study groups. So it was investigated that the average plasma concentration of CNP in patients with AH is higher than in the control group which made it possible to establish a limit level of peptide for screening of individuals with persistent long-term elevation of BP. In men of the control group and in patients with AH the carrier of the Asn allele of the ET-1 gene is associated with a higher level of CNP but in all study groups the Lys/Lys genotype and the Lys allele of the ET-1 gene were dominant.

Метою дослідження є удосконалення ефективності діагностики прогресування ессенціальної гіпертензії (ЕГ) на основі кластерного аналізу, який базується на антропометричних, лабораторних та показниках системної та внутрішньосерцевої гемодинаміки у чоловіків 40-60 років. У дослідження були залучені 50 чоловіків з асимптомною ЕГ у віці- 50,62±0,73 років та 50 чоловіків з ЕГ, що ускладнена хронічною серцевою недостатністю (ХСН), у віці- 51,86±0,81 років. Усім учасникам дослідження виконували стандартне ехокардіографічне обстеження, визначали плазмові концентрації кардіотрофіна-1 (КТ-1) в сироватці крові за допомогою імуноферментного аналізу (ІФА) та поліморфізму (rs8046707) гена КТ-1 у зразках венозної крові методом полімеразної ланцюгової реакції (ПЛР). За допомогою кластерного аналізу виділено фенотиповий портрет пацієнта.