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The significance of ACE gene polymorphism in ischemic heart disease

ACE基因多态性在缺血性心脏病中的意义

基本信息

批准号：
07670801
负责人：
NAKAI Kenji
金额：
$ 1.41万
依托单位：
Iwate Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1995
资助国家：
日本
起止时间：
1995 至 1996
项目状态：
已结题

项目摘要

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.

日本人和西方人在心肌梗塞（MI）与血管紧张素转换酶（ACE）基因多态性的关系上的差异尚未完全阐明。还需要在日本人中进行关于ACE基因多态性与MI后左心室重构之间关系的研究。本研究采用PCR方法检测ACE基因多态性，并与正常对照组和心肌梗死患者进行比较，探讨ACE基因多态性与心肌梗死患者预后及左心室晚电位的关系。通过信号平均心电图确定心室晚电位的存在。此外，还通过信函进行了问卷调查。采用Kaplan-Meier法分析ACE基因多态性与心脏事件发生的关系，并分析ACE基因多态性与首次MI后左心室晚电位的关系。[结果]1）ACE基因DD基因型可能成为新的冠心病危险因素，甚至在日本人中也可能成为缺血性心脏病的危险因素（Circulation，1995）。2)低危组（TC<260 mg/dl，HbAlc<9.0%，BMI<26）首次心肌梗死后心脏事件发生率分别为：ACE Ⅱ型34例中7例（20.6%），ACE ID型71例中15例（21.1%），ACE DD型58例中21例（36.2%）。Kaplan-Meier分析显示，ACE DD基因型MI患者的心脏事件比ACE II和ID基因型MI患者的心脏事件有增加的趋势（Musya T，Nakai K：J Iwate Med，1997.in print）。3)左心室晚电位阳性增加了ACE DD基因型心肌梗死患者的发病率（Nakai K et al：A.N.E.1：405- 410，1996），我们的结论是ACE DD基因型可能与日本人首次心肌梗死后心脏事件的发生和左心室重构有关。