POLYMORPHISM OF TOLL-LIKE RECEPTORS-2 IN PATIENTS WITH CHRONIC RHEUMATIC HEART DISEASE

Aim. To assess the contribution of TLR2 gene polymorphism to echocardiography and spirometry parameters in patients with chronic rheumatic heart disease (CRHD). Materials and Methods. A total of 128 patients with CRHD were examined – 15.6% of men and 84.4% of women. Genotyping by polymorphic markers Arg753Arg, Arg753Gln, Gln753Gln was performed by PCR with SNP-EXPRESS electrophoretic scheme (NPF Litekh, Russia) for detection of the result after extraction of DNA from leukocytes of venous blood. Echocardiography with evaluation of linear dimensions, left ventricular hypertrophy and mitral orifice area was performed on Philips Affinity 50 apparatus; respiration was evaluated using Spirolab II spirometer. Results. The distance of the 6-minute walk test in the groups did not differ significantly: (р=0.168): Arg753Arg–314.75±6.88 m, Arg753Gln–389.69±19.92 m, as well as mitral orifice area (p=0.182): Arg753Arg–1.73(1.66;1.80) cm2 and Arg753Gln–1/70(1.61;1.79) cm2. Echocardiography showed no differences in the size of the left ventricle, but in the group of Arg753Gln heterozygotes, dilatation of the left atrium was significantly higher 5.20(5.08;5.32) cm (Arg753Arg-4.98(4.83;5.13) cm) and of the right ventricle 3.10(2.90;3.30) cm (Arg753Arg-2.66 (2.59;2.72) cm) and less pronounced values of the left ventricular hypertrophy: interventricular septum thickness 1.018(0.92;1.12) cm (Arg753Arg-1.02(0.98;1.05) cm) and of the right atrium 4.40(4.10;4.70) cm (Arg753Arg-4.54(4.33;4.74) cm). In spirometry, values of both obstructive and restrictive parameters were significantly lower in the Arg753Arg homozygous group: forced lung capacity 71.04(66.15;72.94)% (Arg753Gln-84.16(79.68;88,65)%); forced expiratory volume in 1 sec 79,05(76,87;81,23)% (Arg753Gln-88,18(84,40;91.96)%); reserve inspiratory volume 84.88(81.60;88.17)% (Arg753Gln-96.45(86.73;106.18)%); reserve expiratory volume 21.29 (18.08;24.51)% (Arg753Gln-25.93(13.93;37.93)%). Conclusion. In patients with RHD, the contribution of single TLR2 nucleotide replacements to the parameters of echocardiography and spirometry is possible, which is manifested in a decrease in external respiration function in Arg753Arg homozygotes and dilatation of the left atrium and right ventricle in Arg753Gln heterozygotes.