The DD genotype of the angiotensin converting enzyme gene is negatively associated with right ventricular hypertrophy in male patients with chronic obstructive pulmonary disease

The renin angiotensin system plays an important role in the development of pulmonary artery remodeling and right ventricular hypertrophy in hypoxia-in duced pulmonary hypertension as may occur in patients with COPD. Several po lymorphisms of genes encoding for components of the renin angiotensin syste m such as the (MT)-T-235 polymorphism in the angiotensinogen gene, the 287- base-pair insertion (I)/deletion (D) polymorphism at intron 16 of the ACE g ene, and the A(1166)C polymorphism in the angiotensin II type 1 receptor ge ne have been associated with an increased risk of cardiovascular diseases. With respect to the pulmonary circulation, only limited data exist on possi ble associations between polymorphisms of these genes and pulmonary hyperte nsion and/or right ventricular hypertrophy. The objective of the present st udy was to investigate a possible relationship between polymorphisms of the renin angiotensin system and electrocardiographic evidence of right ventri cular hypertrophy in patients with COPD. We therefore determined the angiot ensinogen (M235T), angiotensin converting enzyme (I/D), and angiotensin II type 1 receptor (A(1166)C) genotypes in 87 patients with severe COPD and co rrelated these data with electrocardiographic parameters of right ventricul ar hypertrophy. Thirty-one patients (36%) of 87 patients with COPD showed e lectrocardiographic evidence of right ventricular hypertrophy. In the male, but not in the female, subgroup, the angiotensin-converting enzyme DD geno type was negatively associated with electrocardiographic evidence of right ventricular hypertrophy (male: chi(2) = 3.8, p = 0.05; female: chi(2) = 0.0 5, p = 0.82). We found no associations between the investigated polymorphis ms in the angiotensinogen and angiotensin II type 1 receptor genes and elec trocardiographic evidence of right ventricular hypertrophy.