title: Angiotensin-converting enzyme genetic polymorphism: its impact on cardiac remodeling.
abstract: BACKGROUND
  The role of angiotensin-converting enzyme genetic polymorphisms as a predictor of echocardiographic outcomes on heart failure is yet to be established. The local profile should be identified so that the impact of those genotypes on the Brazilian population could be identified. This is the first study on exclusively non-ischemic heart failure over a follow-up longer than 5 years.
  
  
  OBJECTIVE
  To determine the distribution of angiotensin-converting enzyme genetic polymorphism variants and their relation with echocardiographic outcome of patients with non-ischemic heart failure.
  
  
  METHODS
  Secondary analysis of the medical records of 111 patients and identification of the angiotensin-converting enzyme genetic polymorphism variants, classified as DD (Deletion/Deletion), DI (Deletion/Insertion) or II (Insertion/Insertion).
  
  
  RESULTS
  The cohort means were as follows: follow-up, 64.9 months; age, 59.5 years; male sex, 60.4%; white skin color, 51.4%; use of beta-blockers, 98.2%; and use of angiotensin-converting-enzyme inhibitors or angiotensin receptor blocker, 89.2%. The angiotensin-converting enzyme genetic polymorphism distribution was as follows: DD, 51.4%; DI, 44.1%; and II, 4.5%. No difference regarding the clinical characteristics or treatment was observed between the groups. The final left ventricular systolic diameter was the only isolated echocardiographic variable that significantly differed between the angiotensin-converting enzyme genetic polymorphisms: 59.2 ± 1.8 for DD versus 52.3 ± 1.9 for DI versus 59.2 ± 5.2 for II (p = 0.029). Considering the evolutionary behavior, all echocardiographic variables (difference between the left ventricular ejection fraction at the last and first consultation; difference between the left ventricular systolic diameter at the last and first consultation; and difference between the left ventricular diastolic diameter at the last and first consultation) differed between the genotypes (p = 0.024; p = 0.002; and p = 0.021, respectively).
  
  
  CONCLUSIONS
  The distribution of the angiotensin-converting enzyme genetic polymorphisms differed from that of other studies with a very small number of II. The DD genotype was independently associated with worse echocardiographic outcome, while the DI genotype, with the best echocardiographic profile (increased left ventricular ejection fraction and decreased left ventricular diameters).
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Felipe Neves de
authors.initials: FN
authors.lastname: Albuquerque
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Andréa Araujo
authors.initials: AA
authors.lastname: Brandão
authors.affiliation: Universidade do Estado do Rio de Janeiro, Instituto de Biologia Roberto Alcantara Gomes, Laboratório de Diagnósticos por DNA, Rio de JaneiroRJ, Brasil.
authors.forename: Dayse Aparecida da
authors.initials: DA
authors.lastname: Silva
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mourilhe-Rocha
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Gustavo Salgado
authors.initials: GS
authors.lastname: Duque
authors.forename: Alyne Freitas Pereira
authors.initials: AF
authors.lastname: Gondar
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Luiza Maceira de Almeida
authors.initials: LM
authors.lastname: Neves
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Marcelo Imbroinise
authors.initials: MI
authors.lastname: Bittencourt
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pozzan
authors.affiliation: Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Rio de JaneiroRJ, Brasil.
authors.forename: Denilson Campos de
authors.initials: DC
authors.lastname: Albuquerque
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D017353:Gene Deletion; D005838:Genotype; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics*; D013318:Stroke Volume / Q000235:genetics; D013997:Time Factors; D014463:Ultrasonography; D020257:Ventricular Remodeling / Q000235:genetics*
chemical_list: D007703:Peptidyl-Dipeptidase A