[Effect of the polymorphism of the angiotensin-converting enzyme gene on the drug treatment in patients with chronic heart failure].
摘要
OBJECTIVE: To investigate the effect of the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene on the drug treatment in patients with chronic heart failure. METHODS: The genotype was determined by polymerase chain reaction (PCR) in 79 patients with chronic heart failure. Plasma Ang II levels that were assessed by radio-immunity assay (RIA), left ventricular end-diastolic diameters (LVDD) and left ventricular ejection fractions (EF) and that were studied with echocardiography were measured before and after the treatment. RESULTS: ACE gene DD polymorphism was associated with greater LVDDs [DD vs. ID (P <0.001), DD vs. II (P < 0.001)], higher plasma Ang II levels [DD vs. ID (P < 0.05), DD vs. II (P < 0.001)] and the greatest decreased magnitude of plasma Ang II levels after treatment [DD vs. ID (P < 0.05), DD vs. II (P < 0.001)]. CONCLUSION: In patients with chronic heart failure, ACE gene DD polymorphism might be a marker of a higher level of activation of the renin-angiotensin system (RAS). Patients with the DD allele would expect a greater beneficial effect on endocrine by the drug treatment including ACE inhibitor and beta-blocker.