Angiotensin-II type 1 receptor gene polymorphism and long-term survival inpatients with idiopathic congestive heart failure

Background: It has been suggested that a genetic polymorphism in the angiot ensin II type 1 receptor gene (ATRG) and the ACE gene DD genotype might hav e a synergistic influence on the risk of developing cardiovascular disease. Aims: To study the possible interaction between polymorphisms in the ACE g ene and the ATRG, regarding survival and left ventricular function. Methods : Polymorphism of the two genes was studied in a population-based cohort of 194 patients with idiopathic heart failure, recruited from the western par t of Sweden 1985-1988. The patients were investigated by echocardiography. The survival status was checked during the 7-year follow-up period. Results : Although there was no statistically significant additive risk of the ATRG polymorphism, patients carrying the ACE gene DD genotype in combination wi th a C allele of the ATRG tended to have a poorer prognosis. DD + AA, OR 1. 24 (95% CI 0.67-2.32, P = 0.49); DD + AC, OR 1.64 (95% CI 0.95-2.83, P = 0. 08); DD + CC, OR 3.54 95% CI 0.78-16.1, P = 0.10); DD + AC / CC, OR 1.84 (9 5% CI 1.10-3.08, P = 0.02). Patients with the DD + AC / CC genotypes tended to have lower ejection fraction and increased left ventricular mass. Concl usions: There was a trend toward a worse prognosis in patients with the com bination of a C-allele in the ATRG and the ACE gene DD genotype, suggesting an interaction of these two genetic polymorophisms on disease severity. (C ) 1999 European Society of Cardiology. All rights reserved.