Brain natriuretic peptide in the diagnosis of structural and functional changes of the myocardium in men with uncomplicated and asymptomatic hypertension with polymorphic variants of aldosteronesynthase gene

Abstract

According to previous studies, aldosterone is responsible for myocardial remodeling and, ultimately, myocardial dysfunction. Aldosterone synthase gene (CYP11B2) as the main controller of aldosterone may be involved in the variability of renin-angiotensin-aldosterone system (RAAS) activity. Brain natriuretic peptide (BNP) is a marker for the diagnosis of chronic heart failure and it’s a contraregulatory peptide of RAAS. The aim of our study was to investigate the levels of BNP plasma concentrations in men with uncomplicated hypertension, carriers of polymorphic variants of the CYP11B2 gene. The study involved 150 men: 50 men of control group and 100 men of main group patients with hypertension of I-II stages. Each participant underwent office blood pressure measurement, echocardiography, determination of plasma levels of BNP in serum by immunoassay (ELISA) and determination of C-344T polymorphism of CYP11B2 gene in venous blood samples by PCR. Mathematical processing of obtained data was performed using standard statistical package STATISTICA 10.0. In accordance with the normal distribution, obtained results were presented as mean and standard deviation. In case of discrepancy of normal distribution a median of 25-75% of quartiles, including half of all parameter values, was given. For comparing groups by investigated parameters, the Student's t test was used for normal distribution, and in the absence of normal distribution, its non-parametric analogs were used: the Mann-Whitney or ANOVA test. It was found that male carriers of CC polymorphism of CYP11B2 gene had higher plasma concentrations of BNP and in the group of patients with essential hypertension and left ventricle hypertrophy (LVH) the representatives of this polymorphic variant of CYP11B2 gene had more severe diastolic disorders and signs of myocardial remodeling. The TT carrier of the CYP11B2 gene polymorphism was associated with excess body mass and lower BNP levels.