(Circulation. 1997;96:741-747.)
© 1997 American Heart Association, Inc.
Articles |
Association of Angiotensin-Converting Enzyme Gene I/D Polymorphism With Change in Left Ventricular Mass in Response to Physical Training
From The Hatter Institute for Cardiovascular Research University College, London Medical Schools, University College Hospital, London (H.E.M., C.M.D., M.G., J.R.M.); Department of Vascular Physiology, Great Ormond Street Hospital, London (J.D., P.C.); Department of Cardiological Sciences, St Georges Hospital, London (K.P., M.-A.L., D.S., A.V., W.J.M.); Cardiovascular Genetics Unit, Department of Medicine, Rayne Institute, University College, London Medical Schools, London (P.T., S.H.); Army Training Regiment, Bassingbourn, Herts (M.J.); Royal Army Medical College, Millbank, London (M.W.); and Department of Epidemiology and Public Health, UCLMS, London WCIE (H.H.), UK.
Correspondence to Dr Hugh Montgomery, BSc, MB BS, MRCP, Hatter Institute for Cardiovascular Research, Department of Cardiology, UCH, Grafton Way, London WC1E 6DB, UK.
Background The absence (deletion allele [D]) of a 287–base pair marker in the ACE gene is associated with higher ACE levels than its presence (insertion allele [I]). If renin-angiotensin systems regulate left ventricular (LV) growth, then individuals of DD genotype might show a greater hypertrophic response than those of II genotype. We tested this hypothesis by studying exercise-induced LV hypertrophy.
Methods and Results Echocardiographically determined LV dimensions and mass (n=140), electrocardiographically determined LV mass and frequency of LV hypertrophy (LVH) (n=121), and plasma brain natriuretic peptide (BNP) levels (n=49) were compared at the start and end of a 10-week physical training period in male Caucasian military recruits. Septal and posterior wall thicknesses increased with training, and LV mass increased by 18% (all P<.0001). Response magnitude was strongly associated with ACE genotype: mean LV mass altered by +2.0, +38.5, and +42.3 g in II, ID and DD, respectively (P<.0001). The prevalence of electrocardiographically defined LVH rose significantly only among those of DD genotype (from 6 of 24 before training to 11 of 24 after training, P<.01). Plasma brain natriuretic peptide levels rose by 56.0 and 11.5 pg/mL for DD and II, respectively (P<.001).
Conclusions Exercise-induced LV growth in young males is strongly associated with the ACE I/D polymorphism.
Key Words: angiotensin • mortality • genetics • hypertrophy
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