Ohmichi N, Iwai N, Maeda K, Shimoike H, Nakamura Y, Izumi M, Sugimoto Y, Kinoshita M
First Department of Internal Medicine, Shiga University of Medical Sciences, Japan.
Int J Cardiol. 1996 Mar;53(3):265-72. doi: 10.1016/0167-5273(96)02562-4.
The purpose of the present study was to assess whether the insertion (I)/deletion (D) polymorphism of the angiotensin converting enzyme (ACE) gene, and the polymorphism of angiotensinogen (AGT) gene with threonine (T) instead of methionine (M) at amino acid 235 in exon 2 (M235T) were associated with left ventricular dilatation after myocardial infarction. In 103 patients with myocardial infarction, the left ventricular (LV) end-diastolic volume index (EDVI) and the end-systolic volume index (ESVI) were assessed by echocardiography at two time points, namely at 7 +/- 4 days and at 3.9 +/- 1.3 months (mean +/- S.D.) after the infarction. The increases in the LVEDVI and LVESVI on the second echocardiogram were significantly higher in subjects with the DD and ID genotypes than in patients with the II genotype (P < 0.05 and P < 0.005, respectively). Multiple regression analysis revealed that the LVESVI at the first echocardiographic examination and the ACE I/D genotype were significant predictors of the LVEDVI and LVESVI at the second echocardiographic examination. However, the AGT M235T genotype was eliminated. In conclusion, the DD and ID genotypes of the ACE gene were significantly associated with the progression of the LVEDVI and LVESVI after myocardial infarction. The presence of the deletion allele of the ACE gene may be a risk factor of congestive heart failure after a myocardial infarction.
本研究的目的是评估血管紧张素转换酶（ACE）基因的插入（I）/缺失（D）多态性以及血管紧张素原（AGT）基因外显子2中第235位氨基酸由蛋氨酸（M）替换为苏氨酸（T）的多态性（M235T）是否与心肌梗死后左心室扩张相关。在103例心肌梗死患者中，通过超声心动图在两个时间点评估左心室（LV）舒张末期容积指数（EDVI）和收缩末期容积指数（ESVI），即梗死后7±4天和3.9±1.3个月（平均值±标准差）。DD和ID基因型患者第二次超声心动图检查时LVEDVI和LVESVI的增加显著高于II基因型患者（分别为P<0.05和P<0.005）。多元回归分析显示，第一次超声心动图检查时的LVESVI和ACE I/D基因型是第二次超声心动图检查时LVEDVI和LVESVI的显著预测因子。然而，AGT M235T基因型被排除。总之，ACE基因的DD和ID基因型与心肌梗死后LVEDVI和LVESVI的进展显著相关。ACE基因缺失等位基因的存在可能是心肌梗死后充血性心力衰竭的一个危险因素。
