Relationship between angiotensin-converting enzyme gene polymorphism and severity of aortic valve calcification.
OBJECTIVE
To investigate the role of angiotensin-converting enzyme (ACE) gene polymorphism in patients with degenerative aortic valve calcification (AVC).


METHODS
Our study consisted of 305 Turkish patients of European descent (139 male, 166 female; mean plus or minus age, 68 plus or minus 9 years) referred to our echocardiography laboratory for aortic valve evaluation between June 2, 2003, and April 29, 2005. The severity of AVC was graded from 1 to 6 by echocardiography. We used polymerase chain reaction to determine ACE gene polymorphism.


RESULTS
The ACE insertion/deletion genotype distributions for the study population were in Hardy-Weinberg equilibrium (chi square equals 3.5, P equals .18). The study population was divided into 3 groups based on the severity of AVC: those with grade 1 calcification were in group 1, those with grades 2 to 4 in group 2, and those with grades 5 to 6 in group 3. Group 1 patients were significantly younger, less likely to have hypertension and diabetes, and had higher high-density lipoprotein cholesterol levels. The genotype frequencies were significantly different among groups, with the insertion/insertion genotype being less prevalent in group 3 patients. In multivariate analysis, independent predictors of severe AVC were hypertension (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.8 to 11.0; P less than .001), low high-density lipoprotein cholesterol (OR, 2.7; 95 percent CI, 1.5 to 4.9; P equals .001), and the deletion/deletion and insertion/deletion vs insertion/insertion genotype (OR, 3.2; 95 percent CI, 1.5 to 7.2; P equals .004).


CONCLUSIONS
These results suggest that ACE gene polymorphism may be associated with severe AVC.
Cardiology Department, Ankara University School of Medicine, Bilkent-3 Ufuk Sitesi D1/1, 06800 Ankara, Turkey. ertas@medicine.ankara.edu.tr
Fatih S
FS
Ertas
Taner
T
Hasan
Cagdas
C
Ozdol
Sadi
S
Gulec
Yusuf
Y
Atmaca
Cansin
C
Tulunay
Halil
H
Karabulut
H Tolga
HT
Kocum
Irem
I
Dincer
Kenan S
KS
Kose
Cetin
C
Erol
D000368:Aged; D001021:Aortic Valve / Q000201:enzymology*; D015992:Body Mass Index; D002114:Calcinosis / Q000145:classification / Q000201:enzymology* / Q000235:genetics; D008076:Cholesterol, HDL / Q000097:blood; D004251:DNA Transposable Elements / Q000235:genetics; D048909:Diabetes Complications; D004452:Echocardiography; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006349:Heart Valve Diseases / Q000145:classification / Q000201:enzymology* / Q000235:genetics; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics*; D012307:Risk Factors; D017384:Sequence Deletion / Q000235:genetics
D008076:Cholesterol, HDL; D004251:DNA Transposable Elements; D007703:Peptidyl-Dipeptidase A