Anthropometric and structural and functional parameters of the cardiovascular system in polymorphisms of the angiotensin-converting enzyme gene and endothelial nitric oxide synthase in the context of complex treatment of breast cancer

Aim. To evaluate the influence of the polymorphisms of genes encoding the activity of angiotensin-converting enzyme (ACE, I/D polymorphism, rs4343) and endothelial nitric oxide synthase (NOS, T/C polymorphism, rs 2070744; G/T polymorphism, rs 1799983) on anthropometric and structural and functional indicators of the cardiovascular system in patients undergoing breast cancer combined treatment.
Methods. We evaluated the cardiovascular health of 50 women who received combined treatment of breast cancer. 44 patients were divided into three groups, depending on the polymorphisms of genes. In the study, all women received a comprehensive evaluation of the cardiovascular health at the beginning and at the end of breast cancer treatment.
Results.The data obtained indicate that the presence of the ACE gene allele D (rs 43) in the patient (polymorphism I/D and D/D) determines the predisposition to an increase in weight and body mass index following antitumor therapy; an increase in volume parameters and linear dimensions of the left ventricle, a decrease in the ejection fraction and a change in left ventricular remodeling parameters, disorders of relaxation processes and systolic function of the right ventricle, increased activity of the sympathetic nervous system, lower indicators of endothelium-dependent dilation of the brachial artery before the start of antitumor therapy.
The detection of the G allele of the nitric oxide synthase gene (G/T, rs 1799983) (G/G, G/T polymorphisms) in patients receiving complex breast cancer treatment indicates a predisposition to the following changes: weight gain, body mass index, waist and hip size. The presence of the G allele predisposes to a decreased ejection fraction, left ventricular remodeling processes, deterioration of diastolic function of the left and right ventricles, activation of the sympathetic nervous system and the negative effects of antitumor treatment on the structure of the endothelium and its function.
The C allele of the nitric oxide synthase gene (polymorphisms C/C, T/C) in patients receiving complex breast cancer treatment, determines a predisposition to weight gain, body mass index, decrease in ejection fraction and the development of left ventricular remodeling by the end of antitumor therapy.
Conclusion. Despite the limited use of medical genetic examination in routine clinical practice, the study substantiated the determination of polymorphisms of the angiotensin-converting enzyme gene (rs 4343, polymorphism I/D) and nitric oxide synthase (polymorphisms T/C, rs 2070744 and G/T, rs 1799983) to identify individual predisposition to the development of cardiovascular complications of antitumor therapy for breast cancer.

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