e-ISSN 2329-0072




The influence of insertion/deletion (I/D) Angiotensin-Converting Enzyme (ACE) gene polymorphism on development of early post-myocardial infarction left ventricular dysfunction in patients with a first ST-segment elevation myocardial infarction treated with primary coronary angioplasty

Łukasz Polak, Anna Ledakowicz-Polak, Iwona Szadkowska, Krzysztof Chiżyński

Med Sci Tech 2009; 50(1): RA23-28

ID: 881659

Available online:

Published: 2009-03-22

Introduction: The insertion-deletion (I/D) polymorphism of angiotensin converting enzyme (ACE) gene is best known and yet thoroughly studied as well as DD genotype is claimed to be the independent genetic marker predisposing to variety of cardiovascular diseases including acute myocardial infarction (AMI) and heart failure after AMI. The aim of the study was to evaluate whether I/D ACE gene polymorphism may influence symptoms of left ventricular dysfunction and subsequent heart failure in patients after AMI treated with primary coronary intervention (pPCI). Material and methods: 117 consecutive patients with AMI treated with pPCI and stent implantation were enrolled to the study. Genotyping in intron 16 of ACE gene was performed by means of polymerase chain reaction (PCR). Transthoracic echocardiography was performed on 4th-5th day after AMI with assessment of LV ejection fraction (EF), routine LV systolic and diastolic diameters (LVsD, LVdD) and volumes (LVEsV, LVEdV) as well as wall motion index (WMI). Results: Left ventricular dysfunction described as EF<55% was connected with higher frequency of anterior-lateral AMI localization (p<0.001) and longer time from the onset of chest pain to pPCI (p=0.019). Moreover, more than threefold higher values of WMI (OR=3.036; 95%CI 1.047-8.805; p=0.041) as well as approximately 2.5-fold higher LVsD values (OR=2.503; 95%CI 1.083-5.789; p=0.032) were observed in DD genotype carriers when compared to ID heterozygotic patients. Univariate logistic regression did not reveal significant correlation between I/D ACE gene polymorphism and EF values. Conclusions: Adverse DD genotype of ACE gene considerably correlates with selected echocardiographic parameters of LV structure and function impairment measured on 4th-5th day after AMI. (Clin Exp Med Lett 2009; 50(1)23-28)

Keywords: acute myocardial infarction, I/D ACE gene polymorphism, left ventricular dysfunction