INFLUENCE OF THE ANGIOTENSIN-CONVERTING ENZYME I D GENE POLYMORPHISMSON LEFT-VENTRICULAR DIASTOLIC FILLING IN PATIENTS WITH ESSENTIAL-HYPERTENSION/

Background An insertion/deletion (I/D) polymorphism in the angiotensin converting enzyme (ACE) gene accounts for 50% of the variance in seru m ACE activity, ACE is responsible for the generation of angiotensin I I, which not only has presser and mitogenic activities but also exerts effects on left ventricular diastolic performance. Objective To inves tigate the contribution of genetic polymorphisms at the ACE gene to th e development of diastolic functional abnormalities in 100 patients wi th essential hypertension. Methods and results The left ventricular ma ss (LVMI) of each patient was assessed echocardiographically. We calcu lated peak and integral early:late left ventricular diastolic filling ratios (E:A(p) and E:A(r), respectively) and determined the ACE genoty pe from leukocyte DNA. There was no significant difference in age, sex , blood pressure and LVMI among genotype groups. Analysis of covarianc e modelled for indices of diastolic function, adjusted for age, sex, h eart rate and LVMI, demonstrated that the E:A(p) interacted with age ( P < 0.0001), heart rate (P< 0.001) and ACE genotype (P= 0.018), Simila rly, the E:A(i) interacted with age (P < 0.001), heart rate (P = 0.025 ) and ACE genotype (P = 0.047), There was a strong correlation between the E:A(p) and the LVMI for the DD group (r = -0.81, P< 0.0001) but n ot for the ID (r = -0.03, P= 0.83) and II (r = -0.23, P = 0.23) groups , Conclusions These findings suggest that the I/D polymorphism of the ACE gene influences the relationship between left ventricular mass and echocardiographic left ventricular diastolic filling abnormalities in patients with essential hypertension.