Impact of ACE and ApoE polymorphisms on myocardial perfusion: correlation with myocardial single photon emission computed tomographic imaging.
Coronary artery disease is associated with multiple genetic and environmental risk factors. In this study, we evaluated the correlation of angiotensin l-converting enzyme (ACE) (I/D) and ApoE gene polymorphisms (E2, E3, E4 and g.-219G/T) with myocardial perfusion. We examined 410 patients using exercise-rest myocardial perfusion single photon emission computed tomography (SPECT), in which the summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS) indexes were calculated. Homozygotes for the ACE D allele had greater mean values of SSS (P<0.001) and SDS (P<0.001). In addition, E3 homozygotes, E4 heterozygotes and E4 homozygotes had significantly higher values of SSS and SDS compared with E3 heterozygotes (P<0.001); E4 homozygotes had significantly higher values of SSS and SDS compared with E3 homozygotes. Furthermore, for the g.-219G>T polymorphic site at the promoter region of ApoE gene, the mean values of SSS and SDS were significantly higher for T heterozygotes/homozygotes than for GG homozygotes. Adjusting for all demographic and clinical data using multiple linear regression analysis it was found that ACE D and both ApoE genotypes were independent predictors with a cumulative contribution for the prediction of SSS and SDS. Furthermore, logistic regression analysis revealed that all three genotypes had an independent predictive ability for abnormal SSS (SSS>2). These data provide the first evidence of an association and significant cumulative contribution of the aforementioned genotypes in myocardial perfusion with E4 allele having the strongest association followed by ACE D and ApoE g.-219T alleles.
Georgoulias
Panagiotis
P
Department of Nuclear Medicine, School of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece.
Wozniak
Greta
G
Samara
Maria
M
Chiotoglou
Ioanna
I
Kontos
Angelos
A
Tzavara
Chara
C
Valotassiou
Varvara
V
Georgitsi
Marianthi
M
Aleporou-Marinou
Vassiliki
V
Patrinos
George P
GP
Kollia
Panagoula
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001057:Apolipoproteins E / Q000235:genetics*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000235:genetics; D003326:Coronary Circulation / Q000235:genetics*; D005080:Exercise Test; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D001057:Apolipoproteins E; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D013794:Thallium Radioisotopes; C078700:technetium tc-99m tetrofosmin; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A