Association of genetic, biochemical and functional markers of the condition of the vascular endothelium in chronic heart failure with mid-range ejection fraction

The aim of this study was to analyse genetic (polymorphism 4a/4b gene NOS3), biochemical (endothelin-1) and functional (endothelial function coefficient) markers of a condition of vascular endothelium in patients (n = 65) with chronic heart failure (CHF) with mid-range ejection fraction (40–49%), depending of the stage of the disease and identify the presence of associations between the analyzed markers. Somatically healthy people (n = 65) were examined as a control group. A decrease in the value of the endothelial function coefficient and an increase in the production of endothelin-1 in all groups of patients compared with somatically healthy people were revealed. The severity of these changes was greater in groups of patients with more severe stage of the disease. The analysis of polymorphism 4a/4b gene NOS3 in patients with CHF revealed a statistically significant predominance of the number of patients with a more severe stage of the disease among of patients with polymorphism 4a/4b. Patients with polymorphism 4a/4b had a statistically significant lower value of the endothelial function coefficient and a higher level of endothelin-1 compared patients with polymorphism 4b/4b. Thus, polymorphism 4a/4b is characterized by a deeper lesion of the vascular endothelium in patients with CHF with mid-range ejection fraction and the development of more severe stages of the disease. The obtained data can be used in the aspect of personalized medicine.