Journal of Nippon Medical School: Vol.67 No.2 page.096

Journal of Nippon Medical School

Select Language
in Japanese < > in English

Full Text of this Article

in Japanese PDF (145k)

ArticleTitle A Role of Angiotensin-converting Enzyme Gene Polymorphism in Left Ventricular -Remodeling after Myocardial Infarction-

AuthorList Yuan He, Yoshifumi Tomita, Yoshiki Kusama, Kazuo Munakata, Hiroshi Kishida and Teruo Takano

Affiliation The First Department of Internal Medicine, Nippon Medical School

Language JA

Volume 67

Issue 2

Year 2000

Page 96-104

Received Nobember 5, 1999

Accepted December 14, 1999

Keywords post-myocardial infarction, left ventricular remodeling, angiotensin-converting enzyme gene polymorphism, left ventricular end-diastolic volume index

Abstract Background: Left ventricular remodeling (LVR) process is one of the important secondary sequele after acute myocardial infarction (AMI) . However, little is known about the relationship between LVR and angiotensin converting enzyme (ACE) gene polymorphism as well as endothelial nitric oxide synthase (ecNOS) gene polymorphism. Methods: Coronary angiography and left ventriculography were performed within 24 hours and 30±7 days after AMI onset. All consecutive 24 patients (57±6 years) had acute anterior MI with one vessel disease of left anterior descending artery and successful revascularization therapy during acute phase. Patients were divided into three groups according to the change of end-diastolic volume index (EDVI)(ΔEDVI=EDVI 1 month-EDVI within 24 hrs) ; LVR (+)(ΔEDVI>7.0 ml/m², n=5) , LVR (-)(ΔEDVI<-7.0 ml/m², n=13) , and LVR (+/-)(-7.0<ΔEDVI<7.0 ml/m², n=6) groups. The polymorphisms of ACE and ecNOS gene were determined with PCR method after an extraction of genomic DNA from peripheral leukocytes. Results: There were no significant difference among three groups as to baseline characteristics, including coronary risk factors, medications, serum CPKmax and patency of infarct-related artery. The incidence of DD genotype of ACE gene is significantly higher in LVR (+) than in the other two groups (0.60; 0; 0, respectively, χ²=13.150, p<0.01) . The incidence of D allele of ACE gene is also significantly higher in LVR (+) than in the other two groups (0.70; 0.17; 0.19, respectively, χ²=10.221, p<0.01) . ΔEDVI of DD genotype was significantly greater than in the other two groups (DD genotype=30.1±18.1; ID genotype=-13.0±27.4; II genotype=-8.2±11.5ml/m², respectively, p<0.05) . There was no significant difference in ecNOS gene polymorphism among three groups. By stepwise regression analysis, the significant independent predictors of ΔEDVI were EDVI within 24 hrs and DD genotype (F=16.88 and 8.641, respectively, p=0.0024) . Conclusion: These results showed that left ventricular dilatation is related to DD genotype of ACE gene after successful reperfusion therapy of anterior AMI. Thus, renin-angiotensin system may play an important role in left ventricular remodeling after AMI.

Correspondence to

ArticleTitle	A Role of Angiotensin-converting Enzyme Gene Polymorphism in Left Ventricular -Remodeling after Myocardial Infarction-
AuthorList	Yuan He, Yoshifumi Tomita, Yoshiki Kusama, Kazuo Munakata, Hiroshi Kishida and Teruo Takano
Affiliation	The First Department of Internal Medicine, Nippon Medical School
Language	JA
Volume	67
Issue	2
Year	2000
Page	96-104
Received	Nobember 5, 1999
Accepted	December 14, 1999
Keywords	post-myocardial infarction, left ventricular remodeling, angiotensin-converting enzyme gene polymorphism, left ventricular end-diastolic volume index
Abstract	Background: Left ventricular remodeling (LVR) process is one of the important secondary sequele after acute myocardial infarction (AMI) . However, little is known about the relationship between LVR and angiotensin converting enzyme (ACE) gene polymorphism as well as endothelial nitric oxide synthase (ecNOS) gene polymorphism. Methods: Coronary angiography and left ventriculography were performed within 24 hours and 30±7 days after AMI onset. All consecutive 24 patients (57±6 years) had acute anterior MI with one vessel disease of left anterior descending artery and successful revascularization therapy during acute phase. Patients were divided into three groups according to the change of end-diastolic volume index (EDVI)(ΔEDVI=EDVI 1 month-EDVI within 24 hrs) ; LVR (+)(ΔEDVI>7.0 ml/m², n=5) , LVR (-)(ΔEDVI<-7.0 ml/m², n=13) , and LVR (+/-)(-7.0<ΔEDVI<7.0 ml/m², n=6) groups. The polymorphisms of ACE and ecNOS gene were determined with PCR method after an extraction of genomic DNA from peripheral leukocytes. Results: There were no significant difference among three groups as to baseline characteristics, including coronary risk factors, medications, serum CPKmax and patency of infarct-related artery. The incidence of DD genotype of ACE gene is significantly higher in LVR (+) than in the other two groups (0.60; 0; 0, respectively, χ²=13.150, p<0.01) . The incidence of D allele of ACE gene is also significantly higher in LVR (+) than in the other two groups (0.70; 0.17; 0.19, respectively, χ²=10.221, p<0.01) . ΔEDVI of DD genotype was significantly greater than in the other two groups (DD genotype=30.1±18.1; ID genotype=-13.0±27.4; II genotype=-8.2±11.5ml/m², respectively, p<0.05) . There was no significant difference in ecNOS gene polymorphism among three groups. By stepwise regression analysis, the significant independent predictors of ΔEDVI were EDVI within 24 hrs and DD genotype (F=16.88 and 8.641, respectively, p=0.0024) . Conclusion: These results showed that left ventricular dilatation is related to DD genotype of ACE gene after successful reperfusion therapy of anterior AMI. Thus, renin-angiotensin system may play an important role in left ventricular remodeling after AMI.
Correspondence to