Steeds Richard P, Fletcher Janine, Parry Helen, Chowdhary Saquib, Channer Kevin S, West John, Townend John N
Department of Cardiology, Royal Hallamshire Hospital, Sheffield, UK.
Clin Auton Res. 2002 Apr;12(2):66-71. doi: 10.1007/s102860200022.
Heart rate variability (HRV) is a measure of cardiac autonomic control and is therefore subject to regulation by the renin-angiotensin system. The primary objective of this study was to determine the effect of an insertion/deletion polymorphism within the angiotensin-converting enzyme (ACE) gene on HRV in the early stages after a myocardial infarction at a time when cardiac autonomic control is deranged. The secondary objective was to determine whether this polymorphism affected the HRV response to inhibition of ACE.
149 Caucasian subjects were studied 25 +/- 16 h following MI using time and frequency domain measures of HRV derived from two 5-minute ECG recordings. Recordings were repeated at 182 +/- 65 h following MI, when subjects had been stabilised on ramipril 2.5 mg bd. The study included 46 subjects with the DD genotype, 69 with the ID genotype, and 34 with the II genotype. No effect of the I/D polymorphism on short-term recordings of HRV was found. There was no difference in HRV response to the introduction of ramipril according to the genotypes.
The I/D polymorphism within the ACE gene does not influence HRV after MI or the HRV response to ACE inhibitor therapy with ramipril. These findings may reflect the relative lack of importance of the I/D polymorphism and ACE activity in determining plasma and tissue angiotensin II concentration after a major stimulus to the renin-angiotensin system as occurs after myocardial infarction.
心率变异性（HRV）是心脏自主神经控制的一种测量指标，因此受肾素-血管紧张素系统调节。本研究的主要目的是确定血管紧张素转换酶（ACE）基因插入/缺失多态性对心肌梗死后早期心脏自主神经控制紊乱时HRV的影响。次要目的是确定这种多态性是否影响HRV对ACE抑制的反应。
149名白种人受试者在心肌梗死后25±16小时接受研究，使用从两份5分钟心电图记录中得出的HRV时域和频域测量指标。在心肌梗死后182±65小时重复记录，此时受试者已在每日两次服用2.5毫克雷米普利的情况下病情稳定。该研究包括46名DD基因型受试者、69名ID基因型受试者和34名II基因型受试者。未发现I/D多态性对HRV短期记录有影响。根据基因型，HRV对引入雷米普利的反应没有差异。
ACE基因内的I/D多态性不影响心肌梗死后的HRV或HRV对雷米普利ACE抑制剂治疗的反应。这些发现可能反映了在心肌梗死后对肾素-血管紧张素系统产生重大刺激后，I/D多态性和ACE活性在决定血浆和组织血管紧张素II浓度方面相对缺乏重要性。
