DD-GENOTYPE OF THE ANGIOTENSIN-CONVERTING ENZYME GENE IS A RISK FACTOR FOR LEFT-VENTRICULAR HYPERTROPHY

Background The cardiac renin-angiotensin system has been suggested to be involved in the development of left ventricular hypertrophy. In hum ans, a strong correlation has been found between plasma angiotensin I- converting enzyme (ACE) activity and the insertion/deletion (I/D) poly morphism of the ACE gene, which has been reported to be associated wit h myocardial infarction, ischemic and idiopathic dilated cardiomyopath y, sudden death in hypertrophic cardiomyopathy, and restenosis after p ercutaneous transluminal coronary angioplasty. In the present study, w e examined the possibility that the genotype of the ACE gene might inf luence the development of left ventricular hypertrophy. Methods and Re sults The study population consisted of 268 subjects randomly selected from our outpatient clinic. In 142 subjects, left ventricular mass (L VM) 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 percent age of the explained variance of LVM with variables including diastoli c blood pressure (DBP, P = .0001), body mass index (BMI, P = .0001), s ex (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 g ene 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 = .0 001), and DBP (P = .0001) was 31.25%. Significant differences in the e ffects 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 genotyp es (P = .0091). Conclusions In addition to BMI and DBP, the genotype o f the ACE gene was a significant predictor of LVM and LVM/ht in our st udy population.