Relationship between angiotensin-converting enzyme gene polymorphism and severity of aortic valve calcification

Mayo Clin Proc. 2007 Aug;82(8):944-50. doi: 10.4065/82.8.944.

Abstract

Objective: To investigate the role of angiotensin-converting enzyme (ACE) gene polymorphism in patients with degenerative aortic valve calcification (AVC).

Patients and methods: Our study consisted of 305 Turkish patients of European descent (139 male, 166 female; mean plus or minus age, 68 plus or minus 9 years) referred to our echocardiography laboratory for aortic valve evaluation between June 2, 2003, and April 29, 2005. The severity of AVC was graded from 1 to 6 by echocardiography. We used polymerase chain reaction to determine ACE gene polymorphism.

Results: The ACE insertion/deletion genotype distributions for the study population were in Hardy-Weinberg equilibrium (chi square equals 3.5, P equals .18). The study population was divided into 3 groups based on the severity of AVC: those with grade 1 calcification were in group 1, those with grades 2 to 4 in group 2, and those with grades 5 to 6 in group 3. Group 1 patients were significantly younger, less likely to have hypertension and diabetes, and had higher high-density lipoprotein cholesterol levels. The genotype frequencies were significantly different among groups, with the insertion/insertion genotype being less prevalent in group 3 patients. In multivariate analysis, independent predictors of severe AVC were hypertension (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.8 to 11.0; P less than .001), low high-density lipoprotein cholesterol (OR, 2.7; 95 percent CI, 1.5 to 4.9; P equals .001), and the deletion/deletion and insertion/deletion vs insertion/insertion genotype (OR, 3.2; 95 percent CI, 1.5 to 7.2; P equals .004).

Conclusion: These results suggest that ACE gene polymorphism may be associated with severe AVC.

MeSH terms

  • Aged
  • Aortic Valve / enzymology*
  • Body Mass Index
  • Calcinosis / classification
  • Calcinosis / enzymology*
  • Calcinosis / genetics
  • Cholesterol, HDL / blood
  • DNA Transposable Elements / genetics
  • Diabetes Complications
  • Echocardiography
  • Female
  • Gene Frequency
  • Genotype
  • Heart Valve Diseases / classification
  • Heart Valve Diseases / enzymology*
  • Heart Valve Diseases / genetics
  • Humans
  • Hypertension / complications
  • Male
  • Peptidyl-Dipeptidase A / genetics*
  • Polymorphism, Genetic / genetics*
  • Risk Factors
  • Sequence Deletion / genetics

Substances

  • Cholesterol, HDL
  • DNA Transposable Elements
  • Peptidyl-Dipeptidase A