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Subjects and methods. The study included patients with IDC (group 1; n=111, 89.2% men, average age 51.7±9.7 years) and ICM (group 2; n=110, 91.5% men, average age 58.7±8.4 years). All patients (IDC and ICM) underwent coronary angiography. Based on the anamnesis data and instrumental studies, those patients who could be said to have no risk factors for the development of dilatation of the heart cavities were identified in the group 1. And those patients who were reliably diagnosed with coronary artery disease were in the group 2, that is, dilatation of the heart cavities is due to a previous myocardial infarction, existing angina pectoris. The control group (n=121, average age 53.6±4.8 years) included patients who had no manifestations of cardiovascular diseases. The patients underwent laboratory and instrumental studies, as well as molecular and genetic studies of the A/G polymorphism of the SCN5A gene (rs1805124).Results. In the group with IDC 51.4% of patients were carriers of the common homozygous AA genotype, the heterozygous AG genotype-40.5%, and the rare homozygous GG genotype-8.1%. In the control group 63.3% of patients were identified as carriers of a homozygous genotype by a common allele, and 33.5% were carriers heterozygous genotype, and homozygous genotype for a rare allele – 3.2%. The analysis revealed a statistically significant decrease in the frequency of carrying the homozygous AA genotype in patients with IDC compared to the control group of the rs1805124 polymorphism of the SCN5A gene. In the group of patients with ICM, the А allele (69.5% vs. 80.1%, p=0.003) and the AA genotype (50.9% vs. 63.3%, p=0.030) were significantly less common than in the control group. The rare homozygous GG genotype was statically more common in patients with ICM compared to the control group (11.8% vs. 3.2%, p=0.004). Also, the G allele in the group of patients with ICM was detected statically significantly more often than in the control group (30.5% vs. 19.9%, p= 0.003).Conclusion. The polymorphic locus rs1805124 of the SCN5A gene is associated with both IDC and ICM. Homozygous genotype AA and allele A are conditionally protective factors for the development of these conditions in men.

Aim. To study the association of single nucleotide polymorphism rs556621 (G> T) with development of stroke in patients of the East Siberian population with cardiovascular pathology and risk factors.Material and methods. The study involved 260 patients (157 men and 103 women) with stroke (mean age 57.0 [51.0-62.0]) and 272 patients (170 men and 102 women) of the control group (mean age 55.0 [51.0-62.0]). The examination of the main group included: collection of complaints, anamnesis, clinical examination, computed tomography of the brain, electrocardiography, echocardioscopy, ultrasound duplex scanning of extracranial brachiocephalic arteries, daily blood pressure and heart rate monitoring, analysis of the blood coagulation system. The patients of the main group have arterial hypertension, paroxysmal supraventricular tachycardias, dyslipidemia, atherosclerosis of the brachiocephalic arteries, disorders of the hemostatic system. The control group was studied in the framework of the HAPIEE international project. Molecular genetic research was performed by real-time polymerase chain reaction.Results. There were no statistically significant differences in the frequencies of genotypes and single nucleotide polymorphism rs556621 alleles (G>T) in the subgroup of patients with stroke and those in the control group. The frequency of the rare TT genotype among patients with stroke was 13.3%±4.16, among healthy individuals – 8.8±3.37% (p=0.1). Gender differences when comparing the frequencies of genotypes and alleles were also not detected (p>0.05). The frequencies of the TT genotype were approximately the same in the subgroup of patients with arterial hypertension (13.1%±4.22) and in the control group (7.4±5.25%; p>0.05). No significant differences were observed in the frequencies of the rare genotype of the studied polymorphism in the subgroup of patients with supraventricular tachycardias (20.0±14.37%), hypercoagulability (15.9±7.64%) and the control group (8.8±3.37%), p>0.05. A statistically significant relationship was found between the rare genotype TT of single nucleotide polymorphism rs556621 (G>T) and the development of stroke in patients with dyslipidemia and atherosclerotic lesions of the coronary arteries (p=0.041; odds ratio 1.86, 95% confidence interval 1.02-3.41).Conclusion. The genotype of TTs of single nucleotide polymorphism rs556621 (G> T) increases the risk of developing stroke in patients with dyslipidemia and atherosclerosis of the brachiocephalic arteries compared with carriers of the GG and GT genotypes. The obtained data are recommended to be considered when prescribing lipid-lowering and antithrombotic therapy.

Aim. To study the combined effect of cardiovascular risk factors and genetic markers that encode the proteins of the main components of neurophysiological systems (renin-angiotensin-aldosterone, sympathetic-adrenal systems, endothelial dysfunction) on the development of arterial hypertension among the indigenous and non-indigenous population of Mountain Shoriya.Material and methods. We performed a clinical and epidemiological study of the compactly settled population in the remote areas of Mountain Shoriya. This region of middle mountains is situated in the south of Western Siberia. We examined 1409 subjects (901 subjects – the representatives of indigenous nationality [the Shors], 508 subjects – representatives of non-indigenous nationality [90% among them were the representatives of the European ethnicity]). Hypertension was diagnosed according to the National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010). All patients underwent clinical, laboratory and instrumental investigation. Polymorphisms of genes ACE (I/D, rs 4340), АGT (c.803T>C, rs699), AGTR1 (А1166С, rs5186), ADRB1 (с.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs 28365031), MTHFR (c.677С>Т, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) were tested using polymerase chain reaction.Results. Cardiovascular risk factors associated with hypertension in cohort of Shorians: hypercholesterolemia [Odds Ratio (OR) 1.54, low density lipoproteinemia (OR 1.48), violation of carbohydrate metabolism (OR 1.53), obesity (OR 2.25), including its abdominal type (OR 1.53), the family anamnesis of early cardiovascular diseases (OR 1.88)] and rs4340 polymorphisms of the ACE gene (OR 4.39), rs5186 of the AGTR1 gene (OR 10.02); in the cohort of the non-indigenous ethnos – hypercholesterolemia (OR 1.87), hypertriglyceridemia (OR 1.87), obesity (OR 2.75), abdominal obesity (OR 2.73), family anamnesis of early cardiovascular diseases (OR 2.48), the polymorphism rs5186 of the AGTR1 gene (OR 26.77). Genotype G/G ADRB1 gene was characterized by protective effect against hypertension in the Shorians.Conclusion. Evaluation of the complex influence of clinical and genetic factors on the development of hypertension in the population of Mountain Shoriya showed their comparable importance among the indigenous population and the predominance of non-genetic factors among the non-indigenous population.

Background. The search for genetic predictors of stroke development is actively studied in all developed countries due to the need to address the primary prevention of socially significant diseases. Gene CYP17A1 is one of the many genes that can participate in the formation of predisposition to the development of stroke.Aim. To examine association of the single nucleotide polymorphisms rs1004467 CYP17A1 gene with the development of stroke.Material and methods. The study included 184 patients with stroke (active group; 113 men and 71 women; mean age 55.06±9.40 years), 131 of them with ischemic stroke and 41 with hemorrhagic stroke. The comparison group included 251 people with hypertension without stroke (160 men and 91 women; mean age 59.21±6.62 years) and control group – 157 persons without cardiovascular diseases (106 men and 51 women; mean age 54.94±6.64 years). Study participants underwent clinical (collection of complaints, anamnesis, physical examination), laboratory (blood chemistry, lipid profile) and instrumental (computer tomography of the brain, ultrasound duplex scanning of extraand intracranial blood vessels, electrocardiography, echocardioscopy) examination to verify the diagnosis, molecular genetic study of gene polymorphism СУР17А.Results. The study established the association of homozygous genotype AA rs1004467 CYP17A1 gene with the risk of stroke, which is confirmed bya statistically significant increase in the number of carriers of homozygous genotype AA in the common allele A rs1004467 CYP17A1 gene in patients of the main group (73.4±3.3%) compared to the control group (61.8±3.9%; p=0.03). Statistically significant increase in the number of carriers of genotype AA rs1004467 of CYP17A1 gene in patients with hemorrhagic stroke (70.7±7.1%) compared with the control (61.8±3.9%; p=0.01) was revealed. There are no statistically significant associations between the rs1004467 genotypes of CYP17A1 gene and the risk factors of stroke (hypercholesterinemia, burdened hereditary, hypertension, increased intima-media thickness of brachiocephalic arteries).Conclusions. The ability to consider the genetic determinants of brain stroke allows to identify proactively the risk factors of this complex cascade process. Studies of gene polymorphism as a factor of genetic predisposition to various human diseases allow to determine the individual possibilities of optimal therapy for each patient, considering the identified risk factors.

Background. The study of the incidence of risk factors (RF) of stroke for primary and secondary prevention of this disease remains relevant. There are modifiable and non-modifiable RF.Aim. To study the frequency of the main RF in patients with ischemic and hemorrhagic stroke in the urban population of Krasnoyarsk (Eastern Siberia).Material and methods. Examination of 124 patients with an ischemic stroke and 28 with hemorrhagic was performed. Patients received treatment in neurologic center of Krasnoyarsk in 2014 year. The main criterion of inclusion was the confirmed diagnosis of an ischemic or hemorrhagic stroke. All patient had the clinic-tool and neurovisualizing examination and collecting the individual and family anamnesis with examination of modifiable and non-modifiable RF. The research of the neurologic status at patients both with ischemic, and with a hemorrhagic stroke was conducted by the standard technique. Based on results of computer or magnetic resonance imaging of a brain the diagnosis of an ischemic or hemorrhagic stroke was established.Results. A distinctive feature of patients with hemorrhagic stroke was the occurrence of a vascular accident in younger age (6 years earlier) in comparison with ischemic stroke. Among patients with ischemic stroke elevated body mass index (BMI) was in 87 (70.2%) patients, burdened heredity was in 8.1% of cases, and 43.5% of patients were smokers. Among patients with hemorrhagic stroke 16 (57.1%) patients had elevated BMI. People with burdened heredity were not identified among them. Smoking was found in 22 (78.6%) patients in this group.Conclusion. Improvement of treatment and prevention of an ischemic stroke are in many respects connected with clarification of RF and pathogenic mechanisms of its development. The rational pharmacotherapy directed to pointed impact on individual RF can reduce the risk of development of stroke not only at individual, but also at the population level.

Aim. To study the association of the hereditary sick sinus syndrome (SSS) with gene α2B-adrenergic receptor (ADRA2B) polymorphism.Material and methods. 29 families with hereditary primary SSS from the database of the Chair of Therapy № 1 of Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky were included in the study. Group 1 included probands (20 women and 9 men, 58±0.15 y.o.), group 2 – proband relatives of I, II and III degree (65 males and 68 females, 39±0.13 y.o.), group 3 (control) — 89 healthy volunteers. Clinical examination (physical examination, ECG, bicycle ergometry, ECG monitoring, atropine test, electrophysiological study, echocardiography) was performed in all probands and their relatives. The diagnosis of SSS was confirmed by transesophageal left atrium stimulation in 75 individuals. Genotypic examination of gene ADRA2B I/D polymorphism was performed in 213 individuals: 75 SSS-patients, 49 their healthy relatives, 89 healthy volunteers.Results. 3 types of ADRA2B genotypes (II — homozygous wild, ID — heterozygous, DD — homozygous mutant) were founded by allele-specific polymerase chain reaction. Significant prevalence of the homozygous genotype of more rare alleles DD in SSS-patients (28±5.2%) compared to the control group (8.99±3.0%) was found.Conclusion. Study of the genetic marker can be used to identify predisposition to hereditary SSS in the population and individual-family level. SSS due to mutations in genes that regulate cell function of sinus node and the sinoatrial conduct occurs, apparently, extremely rarely.

Aim. To study inheritance patterns of atrial fibrillation (AF) and association of primary and secondary AF with gene polymorphism of β1-adrenoreceptors.Material and methods. 103 probands with AF and their 301 relatives of I, II, III degrees (basic group) and 82 probands without heart diseases and their 163 relatives of I and II degrees (control group) were examined. Examination included evaluation of electrophysiological indicators of sinoatrial node, electrocardiogram monitoring, veloergometry, echocardiography as well as assessment of gene polymorphism of β1-adrenoretseptors.Results. Accumulation of AF in probands families was founded. Segregation analysis of idiopathic AF revealed autosomal-dominant type of its inheritance.Сonclusion. The heterozygote genotype of gene β1-adrenoretseptors Ser49Gly is one of genetic predictors of primary and secondary AF.

Aim. To study the association of hereditary sick sinus syndrome (SSS) with connexin 40 gene (Cx40) polymorphism. Material and methods. 29 families with hereditary SSS were involved into prospective study. Probands were 20 women and 9 men (aged 58±0.15). Relatives, I-III degree of kinship, were 65 men and 68 women (aged 39±0.13). Clinical and instrumental examination was performed in all probands and their relatives. Diagnosis of SSS was verified by transesophageal atrial electrostimulation. Molecular genetic investigation of SSS patients and their relatives was carried out in laboratory of medical genetics of Research Institute of Therapy , Siberian Branch of Russian Academy of Medical Sciences. Results. 71 SSS patients, 44 their healthy relatives, I-III degree of kinship, 197 subjects of control group were genotyped for the polymorphism of 44G>A of gene Cx40. According to allele-specific polymerase chain reaction 3 types of genotypes ADRA2B (II — homozygous wild, ID — heterozygous, DD — homozygous mutant) were found in SSS patients, their relatives and healthy subjects of control group. Conclusion. Significant predominance of the heterozygous genotype 44G>A was found in SSS (45,07±5,9%) patients in comparison with subjects of the control group (29,44±3,2%).