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血管紧张素转换酶的插入/缺失基因多态性与左心室肥厚。对转换酶抑制剂的反应

[I/D gene polymorphism of the angiotensin-converting enzyme and left ventricular hypertrophy. Response to converting enzyme inhibitors].

作者信息

Rugale C, du Cailar G, Ribstein J, Mimran A

机构信息

Service de médecine interne et hypertension artérielle, CHU Montpellier.

出版信息

Arch Mal Coeur Vaiss. 2003 Jul-Aug;96(7-8):772-5.

Abstract

BACKGROUND

The present study was designed to assess whether the angiotensin-converting enzyme (ACE) gene I/D polymorphism influence the ACE inhibitors effect on the regression of left ventricular hypertrophy.

METHODS

Sixty hypertensive subjects never treated by antihypertensive drugs, aged 46 +/- 11 years, were included in the study. Follow-up with ACE inhibitor treatment was 60 +/- 26 months. Genotypes for ACE I/D polymorphism (DD, ID or II) were determined by PCR. The left ventricular mass index (LVMI) was assessed by two-dimensional directed M-mode echocardiography.

RESULTS

ACE genotype distribution was in agreement with the Hardy-Weinberg equilibrium: 21 patients had the DD genotype, 29 were ID, and 10 were II. At baseline, age, systolic arterial pressure and LVMI didn't differ on the basis of genotype. Body mass index was significantly higher in II than in ID and DD groups. Regression of LVMI with ACE inhibitor treatment was similar in the 3 genotypes (-8.9%, -0.6%, -12.1% in DD, ID and II groups respectively). In addition, decrease of systolic arterial pressure was identical in 3 groups.

CONCLUSION

ACE gene I/D polymorphism seems not to influence regression of left ventricular hypertrophy by ACE inhibitors in essential hypertension.

摘要

背景

本研究旨在评估血管紧张素转换酶(ACE)基因I/D多态性是否影响ACE抑制剂对左心室肥厚消退的作用。

方法

60名年龄为46±11岁、从未接受过抗高血压药物治疗的高血压患者纳入本研究。ACE抑制剂治疗的随访时间为60±26个月。通过聚合酶链反应(PCR)确定ACE I/D多态性的基因型(DD、ID或II)。采用二维定向M型超声心动图评估左心室质量指数(LVMI)。

结果

ACE基因型分布符合哈迪-温伯格平衡:21例患者为DD基因型,29例为ID,10例为II。基线时,年龄、收缩压和LVMI在基因型方面无差异。II组的体重指数显著高于ID组和DD组。3种基因型患者经ACE抑制剂治疗后LVMI的消退情况相似(DD组、ID组和II组分别为-8.9%、-0.6%、-12.1%)。此外,3组患者收缩压的降低情况相同。

结论

在原发性高血压中,ACE基因I/D多态性似乎不影响ACE抑制剂对左心室肥厚的消退作用。

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