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The objective of the present study was to analyse the potential synergistic influence of the insertion/deletion polymorphism of the angiotensin-converting enzyme gene ( I/D ACE)  and the  A1166C  polymorphism of the angiotensin-II type 1 receptor gene polymorphisms  (A1166C AT1R)  on the left ventricular size and performance. Three hundred sixty and one consecutive, Caucasian patients with angiographically confirmed coronary artery disease (CAD) were enrolled into the study. Left ventricular diameter, mass and function were evaluated by echocardiography. Screening for the  I/D ACE  and  A1166C AT1R  genotypes was performed by polymerase chain reaction of genomic DNA, followed by restriction enzyme digestion and agarose gel electrophoresis. The  I/D ACE  and  A1166C AT1R  genotypes separately were not significantly associated with the left ventricular size and function parameters in CAD patients. However, trends towards decreased left ventricular ejection fraction (LVEF) as well as increased left ventricular end-diastolic diameter (LVEDD) and left ventricular mass index (LVMI) were observed when patients with genotype  DD + CC/AC  and  DD + CC  were compared to patients homozygous only in one locus ( DD  or  CC) . Significant increase in LVEDD and LVMI was observed only in patients with a history of anterior myocardial infarction with combined genotype  DD + CC/AC  or  DD + CC . This study does not support the role of the  ACE I/D  and  AT1R A1166C  polymorphisms in the determination of the left ventricular size and performance in patients with significant coronary atherosclerosis. However, it indicates that the influence of polymorphisms may be present in specific patient populations.

clinical chemistry and laboratory medicine

Left Ventricular Size, Mass and Function in Relation to Angiotensin-Converting Enzyme Gene and Angiotensin-II Type 1 Receptor Gene Polymorphisms in Patients with Coronary Artery Disease