Orlowska-Baranowska Ewa, Placha Grzegorz, Gaciong Zbigniew, Baranowski Rafal, Zakrzewski Dariusz, Michalek Piotr, Hoffman Piotr, Rawczynska-Englert Irena
Department of Valvular Heart Disease, National Institute of Cardiology, Medical Academy, Warsaw, Poland.
J Heart Valve Dis. 2004 Jul;13(4):574-81.
Factors responsible for cardiac hypertrophy in patients with aortic stenosis (AS) are not well defined. The study aim was to examine the relationship between angiotensin-converting enzyme (ACE) I/D polymorphism and the degree of cardiac hypertrophy in patients with AS.
A total of 392 white patients (159 women, 233 men; age range: 32-82 years) with AS was analyzed, with clinical data, echocardiographic parameters and ACE I/D polymorphism being assessed.
Left ventricular mass index (LVMI) and wall thickness (LVWT) were greater in men than in women (226 +/- 66 versus 200 +/- 68 g/m2, p <0.0001; and 28.4 +/- 4.5 versus 27.3 +/- 4.1 mm, p = 0.02, respectively). In all patients, LVMI was significantly correlated with the maximal aortic gradient, ejection fraction and gender, whereas LVWT was dependent upon maximal aortic gradient, ejection fraction, gender and history of hypertension. In women, cardiac hypertrophy increased with age. Hypertrophy in women aged <66 years correlated with an absence of the DD genotype. In men, a reverse correlation of both LVMI and LVWT with age was observed (higher in younger patients). The presence of a DD genotype in men seemed to have a significant impact on the degree of cardiac hypertrophy.
The degree of left ventricular hypertrophy in patients with AS was higher in men than in women. ACE I/D polymorphism appeared to have a modulating impact on cardiac hypertrophy in patients with AS, notably those aged <66 years. A higher degree of cardiac hypertrophy was seen in men with the DD genotype, and in women without the DD genotype.
主动脉瓣狭窄（AS）患者发生心脏肥大的相关因素尚未完全明确。本研究旨在探讨血管紧张素转换酶（ACE）I/D基因多态性与AS患者心脏肥大程度之间的关系。
共分析了392例患有AS的白人患者（159例女性，233例男性；年龄范围：32 - 82岁），评估了其临床资料、超声心动图参数及ACE I/D基因多态性。
男性的左心室质量指数（LVMI）和室壁厚度（LVWT）高于女性（分别为226±66 vs 200±68 g/m²，p<0.0001；以及28.4±4.5 vs 27.3±4.1 mm，p = 0.02）。在所有患者中，LVMI与最大主动脉瓣压差、射血分数及性别显著相关，而LVWT则取决于最大主动脉瓣压差、射血分数、性别及高血压病史。在女性中，心脏肥大随年龄增加。年龄<66岁的女性中，心脏肥大与DD基因型缺失相关。在男性中，观察到LVMI和LVWT与年龄呈负相关（年轻患者更高）。男性中DD基因型的存在似乎对心脏肥大程度有显著影响。
AS患者中男性的左心室肥大程度高于女性。ACE I/D基因多态性似乎对AS患者的心脏肥大有调节作用，尤其是年龄<66岁的患者。DD基因型的男性和非DD基因型的女性心脏肥大程度更高。
