Effects of angiotensin-converting enzyme gene polymorphism on the left-ventricular function and mass in patients with acromegaly

In this study we have investigated the contribution of the ACE genotype to the development of left-ventricular hypertrophy (LVH) and systolic and dias tolic dysfunctions in acromegalic patients. The study group consisted of 30 acromegalic patients (21 women and 9 men, age: 37.9 +/- 10.8 years, diseas e duration: 9.0 +/- 6.9 years). The distribution of the DD, ID and II genot ypes was 40.0 (n = 12), 46.6 (n = 14) and 13.3% (n = 4), respectively, bein g similar to frequencies observed in a healthy population. Plasma ACE level s were 55.0 +/- 12.0 (45-84), 28.7 +/- 15.7 (8-58) and 24.5 +/- 12.0 (16-33 ) U/I in patients with the DD, ID and II genotype, respectively. The mean s erum ACE activity in the DD genotype was significantly higher than in the h eterozygous group (p < 0.0001). Serum ACE activity showed a significant neg ative association with the mean growth hormone level (r = 0.52, p = 0.007). The LV early diastolic flow velocity/LV presystolic flow velocity (E/A) ra tios were 1.2 +/- 0.4 for the DD genotype, 1.3 +/- 0.3 for the ID genotype and 0.7 +/- 0.1 for the ii genotype. The E/A ratio was considerably lower i n acromegalic patients with the II genotype compared to the other genotypes (p = 0.03). The LV mass index (LVMI) values were 131.5 +/- 4.2 g/m(2) for the DD genotype, 141.7 +/- 50.3 g/m(2) for the ID genotype and 159.6 +/- 48 .2 g/m(2) for the II genotype. However, there was no significant difference in LVMI among allelic groups. AII other indices of systolic and diastolic function were not statistically different in the acromegalic patients. The present data fail to support a role of ACE gene polymorphism in determining LVH in acromegalic patients. However, the I allele may prove as a useful m arker predicting the development of diastolic dysfunction in acromegalic pa tients. Copyright (C) 2000 S. Karger AG, Basel.