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Cardiology Research and Practice
Volume 2011 (2011), Article ID 798658, 6 pages
http://dx.doi.org/10.4061/2011/798658
Research Article

Progression of Left Ventricular Dysfunction and Remodelling under Optimal Medical Therapy in CHF Patients: Role of Individual Genetic Background

Division of Cardiology, Department of Biomedical and Surgical Sciences, University of Verona, 37129 Verona, Italy

Received 25 October 2010; Accepted 25 November 2010

Academic Editor: Javed Butler

Copyright © 2011 Marzia Rigolli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Neurohormonal systems play an important role in chronic heart failure (CHF). Due to interindividual heterogeneity in the benefits of therapy, it may be hypothesized that polymorphisms of neurohormonal systems may affect left ventricular (LV) remodelling and systolic function. We aimed to assess whether genetic background of maximally treated CHF patients predicts variations in LV systolic function and volumes. Methods and Results. We prospectively studied 131 CHF outpatients on optimal treatment for at least six months. Echocardiographic evaluations were performed at baseline and after 12 months. Genotype analysis for ACE I/D, β1adrenergic receptor (AR) Arg389Gly, β2AR Arg16Gly, and β2AR Gln27Glu polymorphisms was performed. No differences in baseline characteristics were detected among subgroups. ACE II was a significant predictor of improvement of LV end-diastolic and end-systolic volume ( 𝑃 = . 0 0 3 and 𝑃 = . 0 0 2 , respectively) but not of LV ejection fraction (LVEF); β1AR389 GlyGly was related to improvement of LVEF ( 𝑃 = . 0 2 ) and LV end-systolic volume ( 𝑃 = . 0 1 ). The predictive value of polymorphisms remained after adjustment for other clinically significant predictors ( 𝑃 < . 0 5 for all). Conclusions. ACE I/D and β1AR Arg389Gly polymorphisms are independent predictors of reverse remodeling and systolic function recovery in CHF patients under optimal treatment.