Relationship Between Arg389Gly Gene Polymorphism And Improved Ventricular Remodeling And Clinical Prognosis In Patients With Chronic Heart Failure

Objective: To investigate the relationship between β1 adrenergic receptor（ADRB1）Arg389Gly gene polymorphism and improved ventricular remodeling ability and clinical prognosis in patients with chronic heart failure.Methods: A total of 150 patients with chronic heart failure admitted to the department of Cardiology of our hospital from December 2019 to April 2021 were selected.Patients were divided into CC group（Arg389Arg）,GC group（Arg389Gly）and GG group（Gly389Gly）according to ADRB1 Arg389 Gly genotype.Indicators at admission were collected for the three groups: Gender,age,etiology,place of residence,resting heart rate,NYHA cardiac function classification,Arg389 Gly genotype,NT-pro BNP,s ST2,cardiac color ultrasound（LVEF,LVDD,LVDS）,etc.,and based on the treatment of heart failure,Patients were treated with metoprolol sustained-release tablets,sakobactri valsartan and other drugs for heart failure.After discharge,patients were followed up for 12 months by outpatient or telephone,and cardiac color doppler ultrasound,NT-PRO BNP,s ST2 and oral drugs were recorded during the period.To compare the changes of cardiac function and the incidence of MACE events（including malignant arrhythmia,heart failure readmission,and cardiogenic death）in patients with chronic heart failure before and after drug treatment.Results: In patients with chronic heart failure,Arg389 Gly genotype frequency was CC（38%）,GC（42%）and GG（20%）,respectively.Age,cause,place of residence,resting heart rate,NHAY grade,NT-Pro BNP,s ST2,LVEF,LVDD and LVDS of the three groups were compared.There were no significant differences（P > 0.05）.After 12 months of follow-up,there was no statistical difference in the titrated dose of metoprolol sustained release tablets and sarsartan among the three groups（all P < 0.05）.There were statistically significant differences in the decrease of NT-PRO BNP,the increase of LVEF and the decrease of LVDD and LVDS among the three groups within one year（all P values < 0.05）,and the increase of LVEF and the decrease of LVDD and LVDS in CC group were significantly better than that in GG group.At 3 months,there was no statistically significant difference in the decrease of s ST2 among the three groups,while there was statistically significant difference at 6 and 12 months（P=0.008,0.007 < 0.05）.The number of MACE events in the three groups during one-year follow-up were as follows: Long-rank test showed P=0.026 < 0.05,suggesting that the incidence of MACE in CC group was significantly lower than that in GC group and GG group.Kaplan-meier curve suggested that the incidence of MACE in CC group was lower than that in GC group and GG group.Conclusions: CC group is better than GG group in improving ventricular remodeling and clinical prognosis of patients with chronic heart failure.We can evaluate the improvement of ventricular remodeling and clinical prognosis of patients according to Arg389 Gly gene polymorphism.