肾素-血管紧张素-醛固酮系统基因多态性对心肌灌注的影响：与心肌单光子发射计算机断层扫描衍生参数的相关性

Impact of renin-angiotensin-aldosterone system polymorphisms on myocardial perfusion: Correlations with myocardial single photon emission computed tomography-derived parameters.

作者信息

Angelidis George, Samara Maria, Papathanassiou Maria, Satra Maria, Valotassiou Varvara, Tsougos Ioannis, Psimadas Dimitrios, Tzavara Chara, Alexiou Sotiria, Koutsikos John, Demakopoulos Nikolaos, Giamouzis Gregory, Triposkiadis Filippos, Skoularigis John, Kollia Panagoula, Georgoulias Panagiotis

机构信息

Department of Nuclear Medicine, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.

Department of Nuclear Medicine, Army Share Fund Hospital (417 NIMTS), Athens, Greece.

出版信息

J Nucl Cardiol. 2019 Aug;26(4):1298-1308. doi: 10.1007/s12350-017-1181-8. Epub 2018 Jan 17.

DOI:10.1007/s12350-017-1181-8

PMID:29344922

Abstract

BACKGROUND

Renin-angiotensin-aldosterone system (RAAS) has an important role in atherosclerosis. We investigated the effects of six RAAS gene polymorphisms on myocardial perfusion.

METHODS AND RESULTS

We examined 810 patients with known or suspected coronary artery disease (CAD) using stress-rest myocardial single-photon emission computed tomography. Summed stress score (SSS), summed rest score (SRS), summed difference score (SDS), transient ischemic dilation (TID), and lung/heart ratio (LHR) were recorded. The following gene polymorphisms were investigated: angiotensin-converting enzyme (ACE) insertion/deletion (I/D), angiotensinogen (AGT) M235T and T174M, angiotensin II type 1 receptor (AT1R) A1166C, renin (REN) C5312T, and angiotensin II type 2 receptor (AT2R) C3123A. The heterozygotes or homozygotes on ACE D allele were 7.54 times more likely to have abnormal SSS, while the AGT (T174M) heterozygotes were 5.19 times more likely to have abnormal SSS. The homozygotes of ACE D had significantly higher values on TID and LHR, while the AGT (T174M) heterozygotes had higher values on TID. The AT1R heterozygotes had greater odds for having SSS ≥ 3. The patients carried AT1R homozygosity of C allele had significantly higher values on TID, while heterozygotes of AT1R had significantly higher values on LHR.

CONCLUSIONS

Among the polymorphisms investigated, ACE D allele had the strongest association with abnormal myocardial perfusion.

摘要

背景

肾素-血管紧张素-醛固酮系统（RAAS）在动脉粥样硬化中起重要作用。我们研究了六种RAAS基因多态性对心肌灌注的影响。

方法与结果

我们使用静息-负荷心肌单光子发射计算机断层扫描对810例已知或疑似冠心病（CAD）患者进行了检查。记录负荷总分（SSS）、静息总分（SRS）、总分差（SDS）、短暂性心肌缺血性扩张（TID）和肺/心比值（LHR）。研究了以下基因多态性：血管紧张素转换酶（ACE）插入/缺失（I/D）、血管紧张素原（AGT）M235T和T174M、血管紧张素II 1型受体（AT1R）A1166C、肾素（REN）C5312T和血管紧张素II 2型受体（AT2R）C3123A。ACE D等位基因的杂合子或纯合子发生异常SSS的可能性高7.54倍，而AGT（T174M）杂合子发生异常SSS的可能性高5.19倍。ACE D纯合子的TID和LHR值显著更高，而AGT（T174M）杂合子的TID值更高。AT1R杂合子发生SSS≥3的几率更大。携带AT1R C等位基因纯合子的患者TID值显著更高，而AT1R杂合子的LHR值显著更高。