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KMID : 1011920140150030013
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International Journal of Arrhythmia
2014 Volume.15 No. 3 p.13 ~ p.23
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Relationship Between Genetic Polymorphisms of Angiotensin Converting Enzyme and the Degree of Electroanatomical Remodeling of Atrium in Patients with Non-valvular Atrial Fibrillation
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Kim Sook-Kyoung
Park Jae-Hyung
Park Yong-Doo
Pak Hui-Nam
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Abstract
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Objectives: The renin-angiotensin system (RAS) has been known to be related to the fibrosis and structural remodeling of atrial fibrillation (AF). We hypothesized that the degrees of left atrial (LA) and left ventricular (LV) remodeling are associated with genetic polymorphisms of angiotensin-converting enzyme (ACE) in patients with non-valvular lone AF.
Methods: Polymorphisms of the ACE gene were determined by direct DNA sequencing and their frequencies were compared with the LA volume, LA/LV ratio, and LA voltage in 351 patients with non-valvular lone AF (age: 54.2 ± 11.1 years, males: 80.3%).
Results: 1. The frequency of genotypes differed significantly between the patients with an LA volume ≥125 mL and <125 mL. The F1129F C (p=0.024), P405P T (p=0.029), T-3927C T (p=0.029), and A-262T A alleles occurred more frequently in patients with an LA volume of ≥125 mL. 2. The F1129F C (p=0.013) and P405P T (p=0.026) alleles were more common in patients with a high LA/LV end-diastolic dimension (LVEDD) ratio (≥0.80) than in those with a low LA/LVEDD ratio (<0.80). 3. We observed a significantly higher frequency of the F1129F T and ACE D alleles in patients with a low LA voltage ≤ 0.7 mV (p=0.045) than in those with a high LA voltage.
Conclusion: This study demonstrated the association between ACE polymorphisms and structural remodeling of the LA in patients with non-valvular AF. A genetic predisposition to specific ACE genotypes may predict LA remodeling and provide the basis for a therapeutic strategy.
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KEYWORD
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atrial fibrillation, angiotensin-converting enzyme, genotype, remodeling
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