B. Andersson et al., Angiotensin-II type 1 receptor gene polymorphism and long-term survival inpatients with idiopathic congestive heart failure, EUR J HE FA, 1(4), 1999, pp. 363-369
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.