Hypertensive left ventricular remodeling and ACE-gene polymorphism

• Published in: Cardiovascular research Vol. 43; no. 1; pp. 192 - 199
• Main Authors: PERTICONE, F, MAIO, R, COSCO, C, CERAVOLO, R, IACOPINO, S, CHELLO, M, MASTROROBERTO, P, TRAMONTANO, D, MATTIOLI, P. L
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.07.1999
• Subjects: Age Factors; Analysis of Variance; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Evaluation Studies as Topic; Female; Genotype; Humans; Hypertension - genetics; Hypertension - pathology; Linear Models; Male; Medical sciences; Middle Aged; Peptidyl-Dipeptidase A - genetics; Polymorphism, Genetic; Risk Factors; Sex Factors; Ventricular Remodeling; Sonography; Human; Hypertension; Echocardiography; Enzyme; Pathogenesis; Cardiovascular disease; Genetic determinism; Left ventricle; Peptidases; Gene; Peptidyl-dipeptidase A; Heart disease; Hydrolases; Peptidyl-dipeptidases; Complication; Hypertrophy; Polymorphism
• ISSN: 0008-6363; 1755-3245
• DOI: 10.1016/S0008-6363(99)00055-3

To evaluate the relationship between ACE-gene polymorphism and left ventricular geometry in never treated hypertensives. We enrolled 200 hypertensive outpatients that underwent clinical and ambulatory blood pressure measurements, echocardiographic evaluation and analysis for insertion (I)/deletion (D) polymorphism by PCR. Patients with normal or increased (> 125 g/m2 in males and > 110 g/m2 in females) left ventricular mass were considered to have concentric remodeling or concentric left ventricular hypertrophy if their relative wall thickness was > or = 0.45. The left ventricular mass index values (g/m2) were 136 +/- 30 in DD genotype, 124 +/- 26 in ID genotype, and 116 +/- 20 in II genotype (DD vs. ID P < 0.005; DD vs. II P < 0.05), and were unrelated to blood pressure. Ninety-six patients presented left ventricular hypertrophy (48.0%): 51 with concentric and 45 with eccentric hypertrophy. The eccentric left ventricular hypertrophy was detected in 32 (36.8%) DD patients, in ten (10.5%) ID patients (P < 0.05), and in three (16.6%) II patients. The relative septal thickness was 0.43 +/- 0.09 in DD genotype, 0.45 +/- 0.08 in ID genotype, and 0.43 +/- 0.10 in II genotype. In DD and ID genotypes, the relative posterior wall thickness (0.37 +/- 0.07 vs. 0.41 +/- 0.07; P < 0.0001) and the end-diastolic left ventricular internal dimension (52.8 +/- 3.3 mm vs. 48.3 +/- 2.8 mm; P < 0.0001) were statistically different. The DD genotype of the ACE-gene is associated with an increased left ventricular mass and with a significantly higher prevalence of eccentric left ventricular hypertrophy, when compared to ID genotype.