Khokhlov AL* and Rybachkova YV
Background: Advances in medical science and the introduction of a huge number of new drugs do not reduce the urgency of effective and safe pharmacotherapy. One of the prognostic criteria of high efficiency of pharmacotherapy in patients with chronic heart failure (CHF) is considered genetic features of the patient.
Materials and methods: Clinical and genetic studies conducted in 111 patients with CHF and arterial hypertension (AH). All patients underwent laboratory and instrumental methods of research. The median age was 63.5+11.6 years. The main cause of heart failure in 90 patients had coronary heart disease (CHD): exertional angina - 64 (57.6%), myocardial infarction (PICS) - 26 (23.4%), and violation of the type of atrial fibrillation of the heart rate - 36 (32.4%). The average duration to CHF 10.5+6.3 years. Polymorphisms of these genes were analyzed in serum: ADD1: 1378, AGT: 704, AGT: 521, AGTR1: 1166, AGTR2: 1675, CYP11B2: -344, GNB3: 825, NOS3: -786, NOS3: 894.
Results: Depending on staging CHF most significant changes were traced by polymorphisms of genes AGTR2: 1675, CYP11B2: -344 and NOS3: -786. In patients with CHF progression of the disease is associated with increased frequency of polymorphisms of genes AGTR2: 1675, CYP11B2: -344, NOS3: -786, AGT: 704, GNB3: 825. The success of pharmacotherapy in the outpatient phase is associated with an increase of 32.2% frequency of gene polymorphism AGTR2 1675 as a combination of mutation homozygotes and heterozygotes, 26.9% - polymorphism GNB3: 825 from heterozygotes. In patients with CHF and CHD is more common gene polymorphism AGTR2: 1675, and in the presence of PICS - a GNB3: 825.
Conclusion: Introduction into clinical practice of individual approach to the choice of drug and dosing regimen based on the factors affecting the pharmacological response will increase the effectiveness and safety of pharmacotherapy.