Genetic determinants of structural heart changes in Uuzbek population patients with arterial hypertension complicated by atrial fibrillation

Abstract Introduction Atrial fibrillation (AF) is one of the most common cardiac rhythm disturbances, significantly increasing the risk of stroke and heart failure. In recent years, considerable attention has been devoted to studying the genetic factors contributing to atrial remodeling. However, the role of genetic variations in the morphofunctional changes of the heart in patients of the Uzbek population remains underexplored. One of the key indicators of structural remodeling is the indexed left atrial volume (ILAV), which reflects the extent of fibrosis and left atrial overload. Aim of the Study: The aim of the study is to investigate the influence of the genetic variants rs6817105 and rs11773845 on structural changes of the left atrium and their possible association with the risk of developing AF in Uzbek patients with arterial hypertension. These results may be used for personalized prediction of cardiovascular complications and optimization of treatment strategies. Methods The study included 158 patients with arterial hypertension and AF. The main parameters used to assess cardiac remodeling were the indexed left atrial volume (ILAV), total left atrial volume (TLAV), and overall myocardial wall thickness (OMWT). Patients were divided into groups based on their genotypes for rs6817105 and rs11773845, followed by a statistical analysis of the association between these SNPs and changes in cardiac structure. Results Analysis of the allele distribution for rs6817105 revealed that the CT allele was present in 50% (44 patients), the CC allele in 31.82% (28 patients), and the TT allele in 18.18% (16 patients). Statistical analysis (χ² = 20.07; p = 0.0004) identified a significant association of this SNP with the development of left atrial fibrosis. Similarly, the genotype for rs11773845 demonstrated a comparable pattern: the AC allele was found in 52.27% (46 patients), the AA allele in 35.23% (31 patients), and the CC allele in 12.5% (11 patients). Statistical analysis confirmed a significant association with atrial fibrosis (χ² = 31.36; p = 0.00002). The average indexed left atrial volume (ILAV) in patients with fibrosis was 50.39 ml/m², indicating marked structural changes. In the regression analysis evaluating the influence of rs6817105 on TLAV and ILAV, it was found that: The CT allele is associated with a trend toward an increase in TLAV (+4.75 ml/m², p = 0.088) and ILAV (p = 0.053). The TT allele is significantly associated with a reduction in TLAV (-5.25 ml/m², p = 0.014) and shows a borderline effect on ILAV (p = 0.051). Conclusion The genetic variations rs6817105 and rs11773845 play a key role in the remodeling of the left atrium by affecting the volumetric characteristics of the heart. The CT allele of rs6817105 and the AC allele of rs11773845 may serve as risk markers for left atrial fibrosis and, consequently, predisposition to AF.

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