Hypertensive left ventricular remodeling and ACE-gene polymorphism.
OBJECTIVE
To evaluate the relationship between ACE-gene polymorphism and left ventricular geometry in never treated hypertensives.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Perticone
F
F
Department of Medicina Sperimentale e Clinica G. Salvatore, Policlinico Mater Domini, Catanzaro, Italy. perticone@unicz.it
Maio
R
R
Cosco
C
C
Ceravolo
R
R
Iacopino
S
S
Chello
M
M
Mastroroberto
P
P
Tramontano
D
D
Mattioli
P L
PL
D000367:Age Factors; D000704:Analysis of Variance; D005069:Evaluation Studies as Topic; D005260:Female; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000235:genetics / Q000473:pathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D012307:Risk Factors; D012737:Sex Factors; D020257:Ventricular Remodeling
D007703:Peptidyl-Dipeptidase A