title: Correlation of angiotensin converting enzyme gene polymorphism with perioperative myocardial protection under extracorporeal circulation.
abstract: OBJECTIVE
  To observe the expression of angiotensin converting enzyme (ACE), angiotensin II (Ang II), cardiac troponin (cTn I), creatine kinase isozymes (CK-MB) and muscle red protein(Myo) after cardiopulmonary bypass (CPB), and to investigate the association of polymorphisms in angiotensin converting enzyme genes and myocardial injury.
  
  
  METHODS
  Sixty-three patients suffered from rheumatic mitral stenosis and scheduled for mitral valve replacement with CPB, were randomly divided into three groups according polymorphisms in angiotensin converting enzyme genes: type II, type ID, type DD (each=21). Blood samples were withdrawn from artery before operation (T1), at the beginning of CPB (T2), 30 min after CPB (T3), (T4) at the end of CPB (T5), 2 h after CPB (T6), 6 h after CPB (T7) to measure the expression of ACE, Ang II, cTn I, CK-MB, Myo.
  
  
  RESULTS
  The level of ACE during and after CPB were significantly higher than those before CPB (P<0.05). As extension of CPB time, the expression of ACE was increased. The level of cTn I, CK-MB, Myo after CPB were significantly higher than those before CPB(P<0.05). The level of cTn I, CK-MB and Myo were highest at T7, T6 and T5 and T7, respectively. The level of ACE, Ang II cTn I in patients with DD genotype was significantly higher than the ID and II genotype (P< 0.05). Besides, the level of ACE, Ang II in patients with ID genotype was significantly higher than the II (P< 0.05).
  
  
  CONCLUSIONS
  There is certain correlation between CPB perioperative midterm ACE and cTn I, Myo, CK-MB. ACE DD genotype is a susceptibility gene of the CPB perioperative myocardial injury.
authors.affiliation: Department of Cardiothoracic Surgery, Second Affiliated Hospital to Nanchang University.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.forename: Xiao
authors.initials: X
authors.lastname: Dong
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Xiao-Qiang
authors.initials: XQ
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zeng
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Wei
authors.forename: Jian-Liang
authors.initials: JL
authors.lastname: Zhou
authors.forename: Yan-Hua
authors.initials: YH
authors.lastname: Tang
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Xu
mesh_terms: D000328:Adult; D000804:Angiotensin II / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000379:methods*; D016009:Chi-Square Distribution; D052279:Creatine Kinase, MB Form / Q000097:blood; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005838:Genotype; D006335:Heart Injuries / Q000097:blood* / Q000201:enzymology / Q000209:etiology / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000601:surgery; D009218:Myosins / Q000097:blood; D007703:Peptidyl-Dipeptidase A / Q000097:blood / Q000145:classification / Q000235:genetics*; D059035:Perioperative Period; D011110:Polymorphism, Genetic; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D000804:Angiotensin II; D052279:Creatine Kinase, MB Form; D007703:Peptidyl-Dipeptidase A; D009218:Myosins