Relationship between ACE gene polymorphism and left ventricular remodeling and prognosis in patient with acute anterior myocardial infarction

doi:10.3969/j.issn.1672-5301.2017.09.007

Abstract：Objective To analyze the relationship between angiotensin converting enzyme (ACE) gene polymorphism and left ventricular remodeling and prognosis in patient with acute anterior myocardial infarction.Methods 164 cases of acute anterior myocardial infarction(AMI) were selected as research subjects.Left ventricular systolic diameter (LVSD),left ventricular end-diastolic diameter (LVDD),left ventricular ejection fraction (LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),myocardial acting Index (MPI) and other indicators were detected by ultrasonic.The peripheral blood DNA of all patients were extract,and the ACE insertion(Ⅰ)/deletion(D) polymorphism was detected by polymerase chain reaction.All patients were followed up for 1 year,the major cardiovascular events(MACE) occurrence were recorded.The relationship between different ACE genotypes and frequency of left ventricular remodeling and MACE was analyzed.Results In the 164 cases of AMI,patients with ACE gene Ⅰ/Ⅰ type was 80 cases,D/D type was 67 cases,Ⅰ/D type was 17 cases,the distribution frequency was of 48.8％,40.8％ and 10.4％ respectively.At 7th day,the MPI,LYEDV,LVESV and LVSD of three groups have significant difference (P＜0.05).MPI,LVESV,LVDD of patients with D/D genotype were decreased than the first day,while LVEDV,LVEF were significantly increased compared to day 1 (P＜0.05).MPI and LYEF in patients with Ⅰ/D genotype between first day and seventh day were different statistically (P＜0.05).The MPI was significantly lower in the D/D genotype group than in the other two groups at seventh day (P＜0.05).The LVEDV was significantly lower in the D/D genotype group than in the Ⅰ/D group at seventh day (P＜0.05).There was no significant difference between the Ⅰ/Ⅰ group and the Ⅰ/Ⅰ group in LVEDV at seventh day(P＞0.05).Ⅰ/D genotype had significantly higher LVESV and LVSD on the seventh day than the other two groups (P＜0.05).Risk of MACE occurrence in D/D genotype significantly increased (OR =17.16),while the risk of MACE in Ⅰ/Ⅰ genotype patients significantly decreased (OR=0.39)(P＜0.05).Conclusion ACE gene polymorphism may affect early post-myocardial infarction remodeling,and D/D type is more likely to occur left ventricular remodeling,and the risk of MACE is significantly higher than the other two genotypes.