© 1999 European Society of Cardiology
Angiotensin-II type 1 receptor gene polymorphism and long-term survival in patients with idiopathic congestive heart failure
a Department of Cardiology, Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital 413 45 Göteborg, Sweden
b Department of Cardiology, Karolinska Institute at Huddinge Hospital Stockholm, Sweden
* Corresponding author. Tel.: +46-31-342-10-00; fax: +46-31-82-37-62. E-mail address: bert.andersson{at}hjl.gu.se
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Abstract |
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Background: It has been suggested that a genetic polymorphism in the angiotensin II type 1 receptor gene (ATRG) and the ACE gene DD genotype might have a synergistic influence on the risk of developing cardiovascular disease.
Aims: To study the possible interaction between polymorphisms in the ACE gene and the ATRG, regarding survival and left ventricular function.
Methods: Polymorphism of the two genes was studied in a population-based cohort of 194 patients with idiopathic heart failure, recruited from the western part of Sweden 1985–1988. The patients were investigated by echocardiography. The survival status was checked during the 7-year follow-up period.
Results: Although there was no statistically significant additive risk of the ATRG polymorphism, patients carrying the ACE gene DD genotype in combination with a C allele of the ATRG tended to have a poorer prognosis. DD + AA, OR 1.24 (95% CI 0.67–2.32, P = 0.49); DD + AC, OR 1.64 (95% CI 0.95–2.83, P = 0.08); DD + CC, OR 3.54 95% CI 0.78–16.1, P = 0.10); DD + AC/CC, OR 1.84 (95% CI 1.10–3.08, P = 0.02). Patients with the DD + AC/CC genotypes tended to have lower ejection fraction and increased left ventricular mass.
Conclusions: There was a trend toward a worse prognosis in patients with the combination of a C-allele in the ATRG and the ACE gene DD genotype, suggesting an interaction of these two genetic polymorophisms on disease severity.
Key Words: Polymorphism (genetics) • Heart failure, congestive • Cardiomyopathy, congestive • Ventricular function, left • Prognosis • Epidemiology, molecular
Received February 15, 1999; Revised July 26, 1999; Accepted August 9, 1999
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