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Mocan O, Rădulescu D, Buzdugan E, Cozma A, Leucuta DC, Bogdan SA, Procopciuc LM. Association between polymorphisms of genes involved in the Renin-Angiotensin-Aldosterone System and the adaptive morphological and functional responses to essential hypertension. Biomed Rep 2021; 15:80. [PMID: 34429966 PMCID: PMC8372125 DOI: 10.3892/br.2021.1456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/13/2021] [Indexed: 12/26/2022] Open
Abstract
Hypertensive cardiac remodeling is illustrated by increased left ventricular (LV) mass index values and/or relative wall thickness (RWT) values >0.42, and functionally by isolated alteration of LV diastole (abnormal relaxation). The aim of the present study was to establish differentiated models of anatomical and functional adaptation to essential hypertension (EHT), in relation to the genetic variants of genes involved in the Renin-Angiotensin-Aldosterone System (RAAS). The M235T-AGT, I/D-ACE, A1166C-R1AngII, A3123C-R2AngII and G83A-REN genotypes were determined using PCR-Restriction Fragment Length Polymorphism in 139 hypertensive subjects. The relationship between the studied RAAS gene polymorphisms with morphological and functional cardiac remodeling was assessed by multiple logistic regression analysis. Patients carrying the C/C, A/C genotypes (A3123C-R2AngII polymorphism) had a 2.72-fold (P=0.033) increased risk of exhibiting an RWT value <0.42; in the multivariate model the risk was 4.02-fold higher (P=0.008). Analysis of LV diastolic dysfunction (LVDD) revealed that hypertensive patients carrying the T/T, M/T genotypes (M235T-AGT polymorphism) had a 2.24-fold (P=0.037) increased risk of developing LVDD and a 2.42-fold increased risk (P=0.039) after adjustment for confounders. Similarly, carriers of the G/G, A/G genotypes (G83A-REN) had a 2.32-fold (P=0.021) increased risk of developing LVDD, and this remained an independent risk factor based on the multivariate model (P=0.033). The results of the present study showed that no particular gene was associated with increased LV mass, but the A3123C-R2AngII polymorphism was associated with a non-concentric type of cardiac response in hypertensive patients. Conversely, the M235T-AGT and G83A-REN polymorphisms were found to be statistically significantly associated with LVDD when assessing abnormal relaxation.
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Affiliation(s)
- Oana Mocan
- Department of Internal Medicine, 5th Medical Clinic, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Dan Rădulescu
- Department of Internal Medicine, 5th Medical Clinic, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Elena Buzdugan
- Department of Internal Medicine, 5th Medical Clinic, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Angela Cozma
- Department of Internal Medicine, 4th Medical Clinic, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Daniel Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Sidonia Alina Bogdan
- Department of Surgery, Faculty of Veterinary Medicine, University of Agricultural Science and Veterinary Medicine, 400372 Cluj-Napoca, Romania
| | - Lucia Maria Procopciuc
- Department of Medical Biochemistry, ‘Iuliu Hațieganu’ University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
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Fajar JK, Pikir BS, Sidarta EP, Berlinda Saka PN, Akbar RR, Heriansyah T. The Gene Polymorphism of Angiotensin-Converting Enzyme Intron Deletion and Angiotensin-Converting Enzyme G2350A in Patients With Left Ventricular Hypertrophy: A Meta-analysis. Indian Heart J 2019; 71:199-206. [PMID: 31543192 PMCID: PMC6796625 DOI: 10.1016/j.ihj.2019.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/18/2019] [Accepted: 07/02/2019] [Indexed: 01/11/2023] Open
Abstract
Objectives The aim of the study was to evaluate the correlation between left ventricular hypertrophy and the gene polymorphism of angiotensin-converting enzyme (ACE) intron deletion (I/D) and ACE G2350A. Methods Information related to the sample size and genotype frequencies was extracted from each study. Results Our results found that the D allele (p = 0.0180) and DD genotype (p = 0.0110) of ACE I/D had a significant association with increasing the risk of left ventricular hypertrophy, whereas the I allele (p = 0.0180), but not II (p = 0.1660) and ID genotypes (p = 0.1430), was associated with decreasing the risk of left ventricular hypertrophy. On other hand, we found that the A allele (p = 0.0020) and GA genotype of ACE G2350A (p = 0.0070) had the correlation with increasing the risk of left ventricular hypertrophy. Conclusions Our meta-analysis reveals that the D allele of ACE I/D and the A allele of ACE G2350A are associated with increasing the risk of left ventricular hypertrophy.
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Affiliation(s)
- Jonny Karunia Fajar
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
| | - Budi Susetio Pikir
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, 60115, Indonesia.
| | - Erdo Puncak Sidarta
- Brawijaya Cardiovascular Research Center, Universitas Brawijaya, Malang, 65145, Indonesia
| | | | | | - Teuku Heriansyah
- Department of Cardiology and Vascular Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
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Yu Jin, Kuznetsova T, Thijs L, Richart T, Stolarz-Skrzypek K, Yanping Liu, Fagard R, Manunta P, Bianchi G, Staessen JA. Association of echocardiographic left ventricular structure with the ACE D/I polymorphism: a meta-analysis. J Renin Angiotensin Aldosterone Syst 2011; 12:243-53. [DOI: 10.1177/1470320310387178] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: In a previous meta-analysis, we derived pooled estimates for the association of left ventricular mass (LVM) and hypertrophy (LVH), as diagnosed by electrocardiography or echocardiography, with the ACE D/I polymorphism. We updated this meta-analysis until May 2009 only considering echocardiographic phenotypes. Methods: We computed pooled estimates from a random-effects model. Results: Across 38 studies, both DD homozygotes ( n = 2440) and DI heterozygotes ( n = 4310) had higher ( p ≤ 0.002) LVM or LVM index than II homozygotes ( n = 2229). Across 21 studies with available data, this was due to increased mean wall thickness (MWT) with no difference in left ventricular internal diameter (LVID). Standardised differences (DD versus II) were 0.39 ( p < 0.001) for LVM, 0.34 ( p = 0.009) for MWT, and 0.066 ( p = 0.26) for LVID. Across 16 studies (4894 participants), the pooled odds ratios of LVH (versus II homozygotes) were 1.11 ( p = 0.29) and 1.02 ( p = 0.88) for the DD and DI genotypes, respectively. Sensitivity analyses were confirmatory. Conclusions: Our meta-analysis supports the hypothesis that the enhanced ACE activity associated with the D allele is associated with higher LV mass. Smaller sample size might explain the lack of significant association with LVH.
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Affiliation(s)
- Yu Jin
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Tom Richart
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium, Genetic Epidemiology Unit, Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Katarzyna Stolarz-Skrzypek
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium, First Department of Cardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Yanping Liu
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium, Department of Ultrasonography, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Robert Fagard
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium
| | - Paolo Manunta
- Divisione di Nefrologia, Dialisi e Ipertensione, Università Vita-Salute, Milan, Italy
| | - Giuseppe Bianchi
- Divisione di Nefrologia, Dialisi e Ipertensione, Università Vita-Salute, Milan, Italy
| | - Jan A Staessen
- Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium, Genetic Epidemiology Unit, Department of Epidemiology, Maastricht University, Maastricht, the Netherlands or
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Payne JR, Dhamrait SS, Gohlke P, Cooper J, Scott RA, Pitsiladis YP, Humphries SE, Rayner B, Montgomery HE. The impact of ACE genotype on serum ACE activity in a black South African male population. Ann Hum Genet 2007; 71:1-7. [PMID: 17227472 DOI: 10.1111/j.1469-1809.2006.00300.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The strong association between the angiotensin I-converting enzyme (ACE) gene I/D polymorphism with serum ACE activity appears lacking in Nigerians and Kenyans, but has not previously been well assessed in others of African origin. This study addressed this issue in an ethnically well defined black South African population. A putative association for the A22982G ACE gene variant, a QTL likely to impact on serum ACE activity, was also sought. Subjects were 200 healthy male black South African volunteers from the Xhosa ethnic group. Venous blood was obtained from all subjects for DNA extraction. ACE I/D and A22982G genotypes were determined and serum ACE activity measured. Age and blood pressure were recorded. For the group as a whole (mean +/- SD age 38.5 +/- 9.8 years, SBP 119.6 +/- 14.1 mmHg, DBP 78.2 +/- 10.1 mmHg) serum ACE activity was 38.2 +/- 11.2 nmol ml(-1)min(-1). ACE I/D genotype was not significantly associated with serum ACE activity. In contrast, the A22982G variant was significantly associated with serum ACE activity, being 35.9 +/- 9.6, 38.1 +/- 10.6 and 42.4 +/- 15.3 nmol ml(-1)min(-1) for AA, AG and GG genotypes respectively; p = 0.03 by ANOVA and p = 0.01 by linear trend. In keeping with the findings in some other African populations, the ACE I/D polymorphism is not strongly associated with serum ACE activity in Xhosa South Africans. As such, it cannot be used as a marker of ACE activity in these subjects. In this regard the use of the A22982G gene variant may be more appropriate.
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Affiliation(s)
- J R Payne
- Centre for Cardiovascular Genetics, University College London, UK
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Abstract
Since the discovery of the polymorphism in the angiotensin converting enzyme (ACE) and the consequences of this polymorphism on the activity levels of the enzyme, numerous association studies have been performed. However, these investigations do not often adhere to the most stringent criteria for such studies. The initial study reporting a positive association of the ACE polymorphism and myocardial infarction showed an increased risk of the DD genotype. This initial association was eventually refuted by a large, well conducted association study, which found a risk ratio of 1.02 after combining their own data with all published data. Although such large, well conducted association studies have not been performed in left ventricular (LV) hypertrophy, the association between DD genotype and hypertrophy is more convincing with a 192% excess risk of LV hypertrophy in untreated hypertensives. The role of ACE genotype in LV growth is well established, especially in athletes. In heart failure, large studies or meta-analyses have not been performed, because most studies have selected different end-points. This hampers a proper meta-analysis of the results obtained in associations with heart failure. As most association studies do not fulfill the criteria for good association studies and use too small sample sizes, it remains important to perform a meta-analysis to add meaning to the results of such studies. Above all, it is important to obey the rules set for association studies, large sample size, small P values, report associations that make biological sense and alleles that affect the gene product in a physiologically meaningful way.
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Affiliation(s)
- Jop H van Berlo
- Department of Cardiology, University Hospital Maastricht, Cardiovascular Research Institute Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
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