| Summary: | Cardiovascular disease (CVD) is Malaysia's leading cause of mortality, accounting for 21.65% and 23.79% of all deaths in government and private hospitals in 2018. It is expected to continue rising in the next few decades. Hypertension-related left ventricular hypertrophy (HT-LVH) is an independent risk factor for cardiovascular mortality and morbidity and a substantial predictor of adverse cardiovascular outcomes. Regression of LVH is associated with reduced cardiovascular complications. However, 33.3% only of hypertensive patients in Malaysia benefit from the blood pressure-lowering effects of antihypertensive medication. Therefore, we anticipate a more minor LVH regression among patients in the country. Copy number variation (CNV) has been implicated in the pathogenesis of HT-LVH. A genome-wide analysis study comparing 100 patients with HT-LVH with 200 hypertensive individuals revealed the presence of 208 rare CNVs in the HT-LVH group. The analysis identified several genes for cardiac development and traits, including IQGAP2, VAV3, F2R, and CDH15. The gene-set was enriched in transcription factors that regulated the "foetal cardiac gene programme" and triggered the hypertrophic cascade by activating pathways associated with Sp1, CREB1, p53, and androgen receptor expression. This shows that controlling pathways associated with foetal cardiac genes may be crucial for LVH treatment. In conclusion, HT-LVH is prevalent among Malaysians, and a rare CNV contributes to its development by disrupting the functional regulation of the foetal cardiac gene programme. © 2023 Nova Science Publishers, Inc. All rights reserved.
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