ACE Insertion/Deletion, But Not −240A>T Polymorphism, Modulates the Severity in Heart Failure. (1st December 2008)

• Record Type: Journal Article
• Authors: Fatini, Cinzia; Sticchi, Elena; Marcucci, Rossella; Said, Abdihakim Abdullahi; Del Pace, Stefano; Verdiani, Valerio; Nozzoli, Carlo; Gensini, Gian Franco; Abbate, Rosanna
• Is Part Of: Journal of investigative medicine. Volume 56:Number 8(2008)
• Page Start: 1004
• Page End: 1010
• Publication Date: 2008-12-01
• Subjects: ACE I/D and −240A>T gene polymorphisms -- NYHA functional class -- heart failure; Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.2310/JIM.0b013e31818e8028
• Languages: English
• ISSNs: 1081-5589

Abstract

Abstract : Objective: ACE gene is reported to be a candidate gene in heart failure. The insertion/deletion (I/D) polymorphism has been observed to be a predictor of mortality in this disease, but no data are available concerning the role of ACE −240A>T polymorphism. In this study, we investigated the role of ACE I/D and −240A>T polymorphisms in influencing both severity and clinical outcomes in patients with heart failure, according to New York Heart Association (NYHA) class. Patients: We studied 323 patients with heart failure (258 men/65 women; age, 70.8 ± 11.5 years) followed-up for 11.9 ± 6.6 months. Results: The ACE D and −240T allele frequency significantly increased according to the NYHA functional class ( P = 0.0002 and P < 0.0001, respectively). No significant difference in ACE polymorphism genotype distribution and allele frequency according to N-terminal pro-brain natriuretic peptide tertiles was observed. At multinomial regression analysis, ACE D but not −240T allele has been evidenced to be a significant and independent predictor of severity for both NYHA III and IV classes ( P = 0.01 and P = 0.004, respectively). The ACE D allele prevalence was higher, even if not significantly in both death and rehospitalization groups in comparison with survivors and nonrehospitalized ( P = 0.6 and P = 0.9, respectively). No difference in −240T allele frequency has been observed for the ACE −240A>T polymorphism, in relation to both death and rehospitalization ( P = 0.1 and P = 0.6, respectively). Conclusions: This study suggests that ACE I/D polymorphism might represent a predisposing factor to severe heart failure, independently of well-known prognostic markers.