The significance of ACE gene polymorphism in ischemic heart disease

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A difference with a Japanese and Westerners in a relation with a myocardial infarction (MI) and an angiotensin converting enzyme (ACE) gene polymorphism has not been fully elucidated. And a research in a Japanese with regard to relation between ACE gene polymorphism and the left ventricular remodeling after a MI are needed. We examined the significance of ACE gene polymorphism in the prognosis and the generation of left ventricular late potentials in healthy control and MI patients.An ACE gene polymorphism was determined with PCR method in gathering DNA from a leukocyte. A presence of ventricular late potential was determined with an signal-averaged electrocardiogram. Also, a questionnaire survey by a letter was carried out. We analyzed a relation between ACE gene polymorphism and the presence of a cardiac events with Kaplan-Meier, and also analyzed the relation to left ventricular late potentials after the first MI.[Results]1) ACE gene DD genotype could become a new coronary risk factor even Japanese ischemic heart disease (Circulation, 1995). 2) Total frequencies of cardiac events in low risk group (TC<260mg/dl, HbAlc<9.0%, BMI<26) after the first MI was 7 from 34 MI cases with ACE II genotype (20.6%), 15 from 71 MI cases with ACE ID genotype (21.1%), 21 from 58 MI cases with ACE DD genotype (36.2%). Kaplan-Meier analysis revealed that cardiac events in MI patients with ACE DD genotype were tendency to be increased than those in MI patients with ACE II and ID genotype (Musya T,Nakai K : J Iwate Med, 1997.in print). 3) A positive left ventricular late potentials increased the incidence in MI patients with an ACE DD genotype (Nakai K et al : A.N.E.1 : 405-410,1996).We concluded that ACE DD genotype might relate to the genesis of cardiac events and left ventricular remodeling after the first MI in the Japanese.