Regression Left Ventricular Hypertrophy in Hypertensive Patients with Gln27Gln (wildtype) ?2-Adrenergic Receptor Receiving Angiotensin II Receptor Blocker (ARB)
Author : M. A. Sjughiarto, L. Haryatia , M. S. Rohman
Upload Date : 19-04-2018
Background: Early studies have shown that the Glu27 β2 Adrenergic Receptor (AR) variant is strongly associated with cardiac hypertrophy in hypertension. 20% of β AR in the heart is β2AR. However, the role of β2AR in LVH regression remain unclear.
Objective: This study aimed to investigate LVH reduction in hypertensive patient being β2 adrenergic receptor polymorphism in respon to beta blocker treatment among ARB treated hypertensive patient.
Methods: This was prospective cohort study was conducted in 39 patient by inclusion criteria. We performed 24-hour ambulatory blood pressure monitoring (24-hr ABPM) in 39 male subject’s who met the inclusion criteria. Hypertension was define according JNC VII criteria. Left ventricular echocardiography was performed with a two-dimensional and M-mode echo by a standard technique to examine LVMi value and LV mass. LVH echocardiography criterias was LVMi value >115g/m2 and/or LVmass >224 grams. Blood pressure and echocardiographic were measured at baseline and at the conclusion of the treatment phase after 6 months of ARB-based therapy. Arg389Gly β1-AR polymorphism was examined using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method and confirmed by sequenzing method. Patient population was classified by genotype Gln27Gln and Gln27Glu .
Result’s: During 6th-month-followup, Gln27Gln group treated with β blocker and ARB had significant reduction for LVMI and LVmass (from 137,11 ± 37,58 to 72,56 ± 28,59 g/m2 (p=0.011) and from 243,22 ± 72,69 to 141,22 ± 36,87 gram (p=0.011), respectively. Whereas, Gln27Glu group did not. Intrestingly, unsignificant reduction in blood pressure was noted in both genotype groups. We also observed both genotype group’s treated with ARB. We found that among both genotype group there was unsignificant reduction in LVMI,LVmass, RWT, and Blood pressure.
Conclusion: In this study we suggest that Gln27Gln group treated with β blocker and ARB had significant reduction for LVMI and LVmass.
KEYWORDS : ?-Adrenergic receptors, polymorphism, left ventricular hypertrophy; angiotensin II receptors blocker
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