Angiotensin-converting enzyme gene polymorphism in arrhythmogenic right ventricular dysplasia: is DD genotype helpful in predicting syncope risk?

Abstract

INTRODUCTION:

Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable disorder characterised by fibrofatty replacement of right ventricular myocytes and increased risk of ventricular arrhythmias and sudden cardiac death. Angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism affects myocardial ACE levels. DD genotype favours myocardial fibrosis and is associated with malignant ventricular tachycardia. The aim of this study was to explore ACE gene polymorphism in ARVD patients.

METHODS:

Twenty-nine patients with ARVD and 24 controls were included. All ARVD patients had documented sustained ventricular tachycardia. Thirteen patients had syncopal episodes. Six patients were resuscitated from sudden cardiac death. ACE gene polymorphism was identified by polymerase chain reaction technique.

RESULTS:

There was no significant difference in DD genotype frequency between ARVD patients and controls (44.8% vs. 45.8%, p=0.94). However, DD genotype frequency was significantly higher in ARVD patients with syncopal episodes compared to those without syncope (69.2% vs. 25.0%, p=0.017, odds ratio:6.750, 95% confidence interval: 1.318-34.565). DD genotype was detected in higher frequency also in patients with a family history of sudden cardiac death (66.7% vs. 39.1%,p=0.36).

CONCLUSION:

High prevalence of DD genotype in ARVD patients with syncope suggests that ACE I/D polymorphism might be useful in identifying high-risk patients for syncope.

• Authors: Beste Ozben, Ibrahim Altun, Veysel Sabri Hancer, Ahmet Kaya Bilge, Azra Meryem Tanrikulu, Reyhan Diz-Kucukkaya, Ali Serdar Fak, Ercument Yilmaz, Kamil Adalet
• Journal: Journal of the renin-angiotensin-aldosterone system : JRAAS (J Renin Angiotensin Aldosterone Syst) Vol. 9 Issue 4 Pg. 215-20 (Dec 2008) ISSN: 1470-3203 [Print] England
• PMID: 19126662 (Publication Type: Journal Article)

Chemical References

• Peptidyl-Dipeptidase A

Topics

• Adult
• Alleles
• Arrhythmogenic Right Ventricular Dysplasia (enzymology, genetics)
• Female
• Genetic Predisposition to Disease
• Humans
• Male
• Peptidyl-Dipeptidase A (genetics)
• Polymorphism, Genetic
• Syncope (complications)