Association between a Deletion Polymorphism of the Angiotensin-Converting-Enzyme Gene and Left Ventricular Hypertrophy

Abstract

The findings suggest that left ventricular hypertrophy is partially determined by genetic disposition. They identify the DD genotype of ACE as a potential genetic marker associated with an elevated risk of left ventricular hypertrophy in middle-aged men.

Lack of association between ACE gene polymorphism and left ventricular hypertrophy in essential hypertension

“…Several studies have emphasized the role of the renin-angiotensin system by showing that I/D polymorphism of the ACE gene is associated with some myocardial diseases, including hypertrophic cardiomyopathy. 3,15 It has been demonstrated that the DD genotype of the ACE gene is accompanied by high plasma ACE activity, and it is believed that the resulting higher local concentrations of angiotensin II could promote inappropriate vascular wall thickening and myocardial hypertrophy. 2 Nevertheless, contradictory findings have been reported about the association of ACE gene polymorphism and LVH in both normotensive [3][4][5][6] and hypertensive populations.…”

“…3,15 It has been demonstrated that the DD genotype of the ACE gene is accompanied by high plasma ACE activity, and it is believed that the resulting higher local concentrations of angiotensin II could promote inappropriate vascular wall thickening and myocardial hypertrophy. 2 Nevertheless, contradictory findings have been reported about the association of ACE gene polymorphism and LVH in both normotensive [3][4][5][6] and hypertensive populations. [7][8][9] Schunkert et al 3 first reported in 1994 a higher prevalence of the DD genotype in subjects with electrocardiographic evidence of LVH.…”

“…It has been suggested that essential hypertensives with this genotype may have an increased myocardial angiotensin II formation, leading to a greater degree of LVH. 2 Despite those data, contradictory findings have been reported about the ACE gene polymorphism and LVH in both normal [3][4][5][6] and hypertensive populations. [7][8][9] The aim of the present study was to evaluate the possible association between the I/D polymorphism of the ACE gene and the presence of LVH in a group of essential hypertensive patients.…”

Antihypertensive treatment modulates the association between the D/I ACE gene polymorphism and left ventricular hypertrophy: a meta-analysis

“…In 12 case-control studies, 7,8,14 -17,21,32,36-39 patients with left ventricular hypertrophy and control subjects were selected from one of the following sampling frames (Table 1): the general population, 14,16,17,39 hypertensive patients examined at the out-patient clinic, 15,21,36 hospitalised patients with hypertension 7,8,38 or renal insufficiency, 37 or men in military service. 32 The definition of left ventricular hypertrophy varied widely among the 12 studies (Table 1).…”

“…Three studies used ECG criteria to define left ventricular hypertrophy. 14,15,32 In two studies, the diagnosis was based on the Sokolov-Lyon index (SV1 + RV5 or V6 у3.5 mV) combined or not with Minnesota code 3.1. (RV5, V6 Ͼ2.6 mV or R I, II, III, aVF у20 mV or RaVL Ͼ12 mV) or the Rautaharju criterion.…”