Heart attack or angina pectoris?

MSU doctors have found a gene responsible for the development of myocardial infarction

MSU Press Service

A group of scientists from Moscow State University investigated the genetic mechanisms behind the development of atherosclerotic vascular changes. The results obtained are potentially of practical importance for assessing the risk of myocardial infarction. An article about the study was published in the International Journal of Clinical and Experimental Medicine (Chotchaeva et al., Association between T-cadherin gene (CDH13) variants and severity of coronary heart disease manifestation).

Coronary heart disease (CHD) is a major medical and social problem. Currently, this disease is one of the main causes of death and disability worldwide. Alexander Balatsky, one of the authors of the work (Medical Research and Educational Center of Lomonosov Moscow State University), says that according to the results of the work, a mutation of a gene encoding a protein called T-cadherin is associated with the nature of the development of coronary heart disease, and in the future this discovery will improve the prediction of the nature of the development of initial atherosclerotic changes.

Often the first manifestation of coronary heart disease is acute coronary syndrome. Intravascular thrombosis occurs on the surface of the damaged atherosclerotic plaque, leading to the development of myocardial infarction (MI).

Narrowing of the artery on ultrasound diagnostics.
The plaque area is marked in green.
Source: Wikimedia Commons

The average size of the stenosis of the infarct-related artery is 48% (this means that the plaque covers 48% of the width of the vessel). Because of this, patients with small plaques prone to rupture may not experience heart pain and other symptoms of myocardial ischemia, but they have a high probability of developing acute MI. In the case when atherosclerotic plaque and coronary heart disease develop gradually, stable angina pectoris (SSN) often becomes the first manifestation of the disease.

"The essence of our work was to find out how the protein T-cadherin affects the development of coronary heart disease, in particular, its onset: sudden myocardial infarction or the gradual development of angina pectoris (heart pain)," says Alexander Balatsky, PhD, doctor of clinical and laboratory diagnostics of Medical Scientific and Educational The Lomonosov Moscow State University Center. – There is evidence that T-cadherin plays a role in the development of cardiovascular diseases, but its functions are not completely clear. We managed to find out that one of the mutations of the T-cadherin gene is still associated with the nature of the development of coronary heart disease."

The study included 285 men aged 26 to 55 years. The group of patients with coronary heart disease included 186 people under the age of 55 who had recently developed the disease.

"We used genetic analysis to find out whether mutations in the T-cadherin gene that affect its amount in cells are associated with the development of a heart attack or angina," says Alexander Balatsky. "The DNA of patients with different onset patterns was selected from the biobank of the Faculty of Fundamental Medicine, after which we compared the mutation rates in different groups and assessed their impact on the development of the disease individually and in combination with such well–known risk factors as obesity, smoking, hypertension and elevated cholesterol levels."

Scientists have found that genetically determined changes in the amount of T-cadherin are associated with the nature of the onset of coronary heart disease – myocardial infarction or stable angina pectoris. This indicates that T-cadherin is involved in the development of atherosclerosis and is able to influence the stability of atherosclerotic lesions. The results obtained in the future can be used to assess the risk of myocardial infarction and predict the nature of the development of initial atherosclerotic changes.

The authors of the study suggest that the study of mutations in the T-cadherin gene will not only help determine its clinical significance, but also help in fundamental research to clarify the functions of this protein.

Portal "Eternal youth" http://vechnayamolodost.ru  07.04.2016