Circulation, Vol 90, 2622-2628, Copyright © 1994 by American Heart Association
N Iwai, N Ohmichi, Y Nakamura and M Kinoshita
BACKGROUND: The cardiac renin-angiotensin system has been suggested to be
involved in the development of left ventricular hypertrophy. In humans, a
strong correlation has been found between plasma angiotensin I-converting
enzyme (ACE) activity and the insertion/deletion (I/D) polymorphism of the
ACE gene, which has been reported to be associated with myocardial
infarction, ischemic and idiopathic dilated cardiomyopathy, sudden death in
hypertrophic cardiomyopathy, and restenosis after percutaneous transluminal
coronary angioplasty. In the present study, we examined the possibility
that the genotype of the ACE gene might influence the development of left
ventricular hypertrophy. METHODS AND RESULTS: The study population
consisted of 268 subjects randomly selected from our outpatient clinic. In
142 subjects, left ventricular mass (LVM) was determined by echocardiogram.
The genotype of the ACE gene was determined by the polymerase chain
reaction. ANCOVA revealed that the genotype of the ACE gene had no effect
on blood pressure. The percentage of the explained variance of LVM with
variables including diastolic blood pressure (DBP, P = .0001), body mass
index (BMI, P = .0001), sex (P = .0009), and the genotype of the ACE gene
(P = .0017) was 34.61%. Significant differences in the effects of the
genotype of the ACE gene on LVM were observed between the II and DD (P =
.0004) and between the ID and DD (P = .0077) genotypes. The percentage of
the explained variance of the LVM/ht ratio with variables including sex (P
= .134), age (P = .3655), the genotype of the ACE gene (P = .0014), BMI (P
= .0001), and DBP (P = .0001) was 31.25%. Significant differences in the
effects of the genotype of the ACE gene on LVM/ht were observed between the
II and DD genotypes (P = .0003) and between the ID and DD genotypes (P =
.0091). CONCLUSIONS: In addition to BMI and DBP, the genotype of the ACE
gene was a significant predictor of LVM and LVM/ht in our study population.
ARTICLES
DD genotype of the angiotensin-converting enzyme gene is a risk factor for left ventricular hypertrophy
First Department of Internal Medicine, Shiga University of Medical Sciences, Japan.
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