Effect of angiotensin-converting enzyme gene polymorphism on left ventricular remodeling after anteroseptal infarction.
OBJECTIVE
Genetic influence on cardiac remodeling is uncertain. The purpose of this study is to determine the effects of polymorphism of the angiotensin-converting enzyme (ACE) gene on cardiac remodeling after myocardial infarction.


METHODS
The subjects were 43 patients with old anteroseptal myocardial infarction. Based on the polymorphism of the ACE gene, they were classified into a deletion group of 25 patients (D/D genotype in 4 and D/I genotype in 21) and an insertion group of 18 patients (all I/I genotype). Echocardiograms were used to determine left ventricular end-diastolic and end-systolic diameters, interventricular septal and posterior wall thicknesses, left ventricular mass, left atrial diameter, and left ventricular ejection fraction. Blood concentrations of atrial and brain natriuretic peptide were also measured.


RESULTS
Left ventricular end-systolic and end-diastolic dimensions, left ventricular mass, and levels of both atrial and brain natriuretic peptide were significantly higher in the deletion group. In contrast, septal thickness, posterior wall thickness, and ejection fraction showed no differences between the two groups.


CONCLUSIONS
In patients with old anteroseptal infarction, ACE gene polymorphism of the D/D and D/I genotypes has a stronger influence on left ventricular remodeling than polymorphism of the I/I genotype.
Nagashima
J
J
Second Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Musha
H
H
So
T
T
Kunishima
T
T
Nobuoka
S
S
Murayama
M
M
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics*; D012044:Regression Analysis; D013318:Stroke Volume; D020257:Ventricular Remodeling / Q000235:genetics* / Q000502:physiology
D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D007703:Peptidyl-Dipeptidase A