Association of ACE gene D polymorphism with left ventricular hypertrophy in patients with diastolic heart failure: A case-control study

Bahramali, E. and Rajabi, M. and Jamshidi, J. and Mousavi, S.M. and Zarghami, M. and Manafi, A. and Firouzabadi, N. (2016) Association of ACE gene D polymorphism with left ventricular hypertrophy in patients with diastolic heart failure: A case-control study. BMJ Open, 6 (2).

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Abstract

Objectives: To explore the association between ACE gene insertion/deletion (I/D) polymorphism with left ventricular hypertrophy (LVH) in patients with hypertension who have developed heart failure with preserved ejection fraction (HFpEF). Being a major contributor to the development of diastolic heart dysfunction, the renin angiotensin aldosterone system and its genetic variations are thought to induce LVH in hypertensive hearts apart from haemodynamic factors. Design: Case control study. Setting: An Iranian referral university hospital. Participants: 176 patients with hypertension and a diagnosis of HFpEF on presence of symptoms of heart failure plus Doppler echocardiographic documentation of left ventricular (LV) diastolic dysfunction and/or elevated NT-proBNP levels. Those with significant coronary, valvular, pericardial and structural heart diseases were excluded as well as patients with atrial fibrillation, renal failure and pulmonary causes of dyspnoea. They were divided into two cohorts of 88 cases with and 88 controls without LVH, after determination of LV mass index, using two-dimensional and M-mode echocardiography. The I/D polymorphism of the ACE gene was determined using the PCR method. Results: The D allele was significantly more prevalent among cases with compared with controls without LVH (p=0.0007). Genotype distributions also differed significantly under additive (p=0.005, OR=0.53, 95 CI 0.34 to 0.84) and recessive (p=0.001, OR=0.29, 95 CI 0.13 to 0.66) models. Conclusions: In patients with hypertension who develop HFpEF, the D allele of the ACE gene is probably associated with the development of LVH. With the detrimental effects of LVH on the heart's diastolic properties, this can signify the role of genetic contributors to the development of HFpEF in patients with hypertension and may serve as a future risk predictor for the disease.

Item Type: Article
Additional Information: cited By 1
Uncontrolled Keywords: amino terminal pro brain natriuretic peptide; dipeptidyl carboxypeptidase, adult; allele; Article; case control study; controlled study; diastolic heart failure; Doppler echocardiography; female; gene frequency; gene insertion; genetic association; genetic variability; genotype; heart left ventricle hypertrophy; human; hypertension; left ventricular diastolic dysfunction; M mode echocardiography; major clinical study; male; middle aged; polymerase chain reaction; renin angiotensin aldosterone system; university hospital
Subjects: QT Physiology
WG Cardiovascular System
Divisions: School of Medicine
Depositing User: Unnamed user with email eprints@fums.ac.ir
Date Deposited: 10 Mar 2017 18:07
Last Modified: 11 Mar 2017 16:22
URI: http://eprints.fums.ac.ir/id/eprint/91

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