Evaluation of Endothelial Nitric Oxide Synthase Gene Polymorphism (T-786 C) in Patients with Slow Coronary Flow

Öz

Objective: Slow coronary flow (SCF) is characterized by delay of opacification of coronary arteries in coronary angiography in the absence of any evident obstructive lesion. Its pathophysiological mechanisms are uncertain. Several hypotheses have been suggested for SCF, including a form of early phase of atherosclerosis, microvascular dysfunction, inflammation, imbalance between vasoconstrictor and vasodilatory factors, and platelet function disorder. Endothelial nitric oxide synthase (eNOS) gene T-786 C polymorphism have been reported to be associated with many vascular disease. The aim of this study was to investigate the association between SCF and eNOS gene T-786 C polymorphism. Materials and Methods: Forty patients with SCF and otherwise normal coronary arteries (mean age 52±9 years), 35 patients with coronsry artery disease (CAD) (mean age 55±9 years) and 30 patients with normal coronary angiograms (mean age 51±8 years) were included in the study. TIMI frame count ≥40 frames for the left anterior descending artery was considered as SCF. T-786 C polymorphisms of the eNOS gene were analysed by polymerase chain reaction. Demographic characteristics and major risk factors for atherosclerosis were evaluated in the study groups. The severity of SCF and CAD was assessed based on the number of involved vessel. Results: There was no significant difference with respect to age and gender between groups. The percentage of smoking was higher in the CAD group than in the SCF and control groups. There was no statistical difference in genotype distribution among the groups. The genotype distribution in SCF group was as follows: TT genotype frequency was 25 (62,5%)k, TC genotype frequency was 12 (30%) and CC genotype frequency was 3 (7,5%). The genotype distribution in CAD group was as follows: TT genotype frequency was 16 (45,7%), TC genotype frequency was 16 (45,7%) and CC genotype frequency was 3 (8,5%). The genotype distribution in control group was as follows: TT genotype frequency was 17 (56,6%), TC genotype frequency was 10 (33,3%) and CC genotype frequency was 3 (10%). In the dominant and recessive models of statistical analysis, there was no statistically significant difference among groups. Conclusions: Our findings show that there is no significant association between T-786 C polymorphism of eNOS gene and SCF in the present study.

Anahtar Kelimeler

• Endothelial nitric oxide synthase
• polymorphism
• slow coronary flow

Yavaş Koroner Akımı Olan Hastalarda Endotelyal Nitrik Oksit Sentaz Gen Polimorfizmin (T-786C) Araştırılması

Öz

Giriş ve Amaç: Yavaş koroner akım (YKA), koroner anjiyografide tıkayıcı lezyon yokluğunda koroner arterlerde opak maddenin gecikmesiyle karakterizedir. Patofizyolojik mekanizmaları belirsizdir. YKA için çeşitli hipotezler sürülmüştür; aterosklerozun erken fazının bir formu, mikrovasküler disfoksiyon, inflamasyon, vazokonstriktör ve vazodilatör faktörler arasındaki dengesizlik ve tromobist fonksiyon bozukluğudur. Endotelyal nitrik oksit sentaz (eNOS) geni T-786C polimorfizminin birçok damarsal hastalıkla ilişkisi bildirilmiştir. Bu çalışmanın amacı YKA ile eNOS gen T-786C polimorfizmi arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Koroner arterleri normal ancak YKA olan 40 hasta (ortalama yaş 52 ± 9 yıl), koroner arter hastalığı (KAH) olan 35 hasta (ortalama yaş 55 ± 9 yıl) ve koroner anjiyografisi normal olan 30 hasta (ortalama yaş 51 ± 8 yıl) çalışmaya alındı. Sol ön inen arterde, TIMI kare sayısı 40 ve üzeri olması YKA olarak kabul edildi. eNOS geni T-786C polimorfizmleri polimeraz zincir reaksiyonu ile analiz edildi. Çalışma gruplarının demografik özellikleri ve ateroskleroz için major risk faktörleri değerlendirildi. YKA ve KAH ciddiyeti etkilenen damar sayısına göre değerlendirildi. Bulgular: Gruplar arasında yaş ve cinsiyet açısından anlamlı fark yoktu. Sigara içme yüzdesi, KAH grubunda diğer gruplardan daha yüksekti. Gruplar arasında genotip dağılımında istatiksel olarak anlamlı fark yoktu. YKA grubunda genotip dağılımı; TT genotip sıklığı 25 (%62,5), TC genotip sıklığı 12 (%30) ve CC genotip sıklığı 3’tü (%7,5). KAH grubunda genotip dağılımı; TT genotip sıklığı 16 (%45,7), TC genotip sıklığı 16 (%45,7) ve CC genotip sıklığı 3’tü (%8,5). Kontrol grubunda genetip dağılımı; TT genotip sıklığı 17 (%56,6), TC genotip sıklığı 10 (%33,3) ve CC genotip sıklığı 3’tü (%10). Dominat ve resesif modellerin istatiksel analizinde gruplar arasında anlamlı bir fark yoktu. Sonuç: Bulgularımız eNOS gen T-786C polimorfizmi ile YKA arasında anlamı bir ilişki olmadığını göstermektedir.

Anahtar Kelimeler

• Endotelyal nitrik oksit sentaz
• polimorfizm
• yavaş koroner akım

Kaynakça

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