Schunkert H, Hengstenberg C, Holmer S R, Broeckel U, Luchner A, Muscholl M W, Kürzinger S, Döring A, Hense H W, Riegger G A
Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Regensburg, Germany.
Circulation. 1999 May 4;99(17):2255-60. doi: 10.1161/01.cir.99.17.2255.
Cardiac growth and function may be modulated in part by trophic effects of neurohormones. Specifically, aldosterone has been shown to stimulate the growth of cardiac myocytes and the accumulation of cardiac extracellular matrix proteins. Moreover, a variant of the aldosterone synthase gene (a cytosine/thymidine exchange at position -344 in the transcriptional regulatory region) has been associated with enlargement and disturbed filling of the left ventricle (LV) in a small sample of young white adults. The aim of the present study was to reinvestigate the implications of aldosterone synthase -344C/T allele status for serum aldosterone levels, blood pressure, and LV structure and function in large population-based samples.
Individuals who participated in the echocardiographic substudy of the third MONICA (MONitoring trends and determinants in CArdiovascular disease) survey (n=1445) or in the second follow-up of the first MONICA survey (n=562) were studied by standardized anthropometric, echocardiographic, and biochemical measurements as well as genotyping for aldosterone synthase -344C/T allele status. In both surveys, the distribution of sex, age, arterial blood pressure, and body mass index was homogeneous in the aldosterone synthase genotype groups. Echocardiographic LV wall thicknesses, dimensions, and mass indexes were not significantly associated with a specific aldosterone synthase genotype. Likewise, no association was detectable with echocardiographic measures of LV systolic or diastolic function. Data were consistent in both samples and not materially different in subgroups defined by age, sex, or intake of antihypertensive medication. Finally, no significant association was observed for aldosterone synthase allele status and serum aldosterone levels in the group of 562 individuals.
The data are not in favor of a significant contribution of the C/T exchange at position -344 in the aldosterone synthase transcriptional regulatory region to the variability of serum aldosterone levels, blood pressure, or cardiac size or function as found in 2 white population-based samples.
心脏的生长和功能可能部分受神经激素的营养作用调节。具体而言，醛固酮已被证明可刺激心肌细胞生长和心脏细胞外基质蛋白的积聚。此外，在一小部分年轻白人成年人样本中，醛固酮合酶基因的一个变体（转录调控区第 -344 位胞嘧啶/胸腺嘧啶交换）与左心室（LV）扩大及充盈异常有关。本研究的目的是在基于人群的大样本中重新研究醛固酮合酶 -344C/T 等位基因状态对血清醛固酮水平、血压以及左心室结构和功能的影响。
参与第三次 MONICA（心血管疾病监测趋势和决定因素）调查超声心动图亚研究（n = 1445）或第一次 MONICA 调查第二次随访（n = 562）的个体，通过标准化人体测量、超声心动图和生化测量以及醛固酮合酶 -344C/T 等位基因状态基因分型进行研究。在两项调查中，醛固酮合酶基因型组中的性别、年龄、动脉血压和体重指数分布均一。超声心动图测量的左心室壁厚度、尺寸和质量指数与特定的醛固酮合酶基因型无显著关联。同样，与左心室收缩或舒张功能的超声心动图测量指标也未发现关联。两个样本的数据一致，在按年龄、性别或抗高血压药物摄入定义的亚组中也无实质性差异。最后，在 562 名个体的组中，未观察到醛固酮合酶等位基因状态与血清醛固酮水平之间存在显著关联。
在两个基于白人人群的样本中，数据不支持醛固酮合酶转录调控区第 -344 位的 C/T 交换对血清醛固酮水平、血压或心脏大小及功能变异性有显著贡献。
