Angiotensin-converting enzyme gene polymorphism influences degree of left ventricular hypertrophy and its regression in patients undergoing operation for aortic stenosis

被引:51
作者
Dellgren, G [1 ]
Eriksson, MJ
Blange, I
Brodin, LÅ
Rådegran, K
Sylvén, C
机构
[1] Huddinge Univ Hosp, Karolinska Inst, Dept Cardiothorac Surg, S-14186 Huddinge, Sweden
[2] Huddinge Univ Hosp, Karolinska Inst, Dept Cardiol, S-14186 Huddinge, Sweden
[3] Karolinska Hosp, Dept Thorac Surg, S-10401 Stockholm, Sweden
[4] Karolinska Hosp, Dept Clin Physiol, S-10401 Stockholm, Sweden
关键词
D O I
10.1016/S0002-9149(99)00464-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been associated with increased left ventricular hypertrophy (LVH) in patients with cardiomyopathy and congestive heart failure. Patients with aortic stenosis (AS) have varying degrees of LVH at a given valve area, The aim of this study was to examine the relation between ACE gene polymorphism and the degree of LVH in patients undergoing operation for AS, Eighty-two patients who underwent operation for AS with a stentless valve were followed prospectively with echocardiographic assessments of left ventricular mass index (LVMI), ACE gene polymorphism was determined by polymerase chain reaction. The genotype (DD, ID, and II) frequency was the same as in healthy controls, The pressure difference across the aortic valve did not differ between genotypes, Patients with the DD genotype of the ACE gene had a higher LVMI (197 +/- 47 g/m(2)) preoperatively than those with ID (175 +/- 41 g/m(2)) or II (155 +/- 43 g/m(2)) genotypes (p = 0.01), LVMI decreased significantly in DD (p <0.001) and ID (p <0.001) genotypes but not in the II genotype during follow-vp (mean 15 months). There was a significant difference in regression of LVMI over time between genotypes (p = 0.0056), with no significant difference between genotypes at follow-up, The DD genotype of the ACE gene is associated with increased preoperative LVH in patients treated surgically for AS. The DD genotype appears to be an important factor which increases hypertrophic myocardial reactivity to pressure overload. (C) 1999 by Excerpta Medica, Inc.
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页码:909 / 913
页数:5
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