Document Detail

Left ventricular hypertrophy with exercise and ACE gene insertion/deletion polymorphism: a randomized controlled trial with losartan.
MedLine Citation:
PMID:  11208681     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Local cardiac renin-angiotensin systems may regulate left ventricular (LV) hypertrophic responses. The absence (deletion [D]) of a 287-bp marker in the ACE gene is associated with greater myocardial ACE levels and exercise-related LV growth than is its presence (insertion [I]), an effect potentially mediated through either increased activity of the cellular growth factor angiotensin II on the angiotensin type 1 (AT(1)) receptor or increased degradation of growth-inhibiting kinins. We sought to confirm ACE genotype-associated exertional LV growth and to clarify the role of the AT(1) receptor in this association. METHODS AND RESULTS: One hundred forty-one British Army recruits homozygous for the ACE gene (79 DD and 62 II) were randomized to receive losartan (25 mg/d, a subhypotensive dose inhibiting tissue AT(1) receptors) or placebo throughout a 10-week physical training program. LV mass, determined by cardiac magnetic resonance, increased with training (8.4 g, P:<0.0001 overall; 12.1 versus 4.8 g for DD versus II genotype in the placebo limb, P:=0.022). LV growth was similar in the losartan arm: 11.0 versus 3.7 g for DD versus II genotypes (P:=0.034). When indexed to lean body mass, LV growth in the II subjects was abolished, whereas it remained in the DD subjects (-0.022 versus 0.131 g/kg, respectively; P:=0.0009). CONCLUSIONS: ACE genotype dependence of exercise-induced LV hypertrophy is confirmed. Additionally, LV growth in DD (unlike II) subjects is in excess of the increase in lean body mass. These effects are not influenced by AT(1) receptor antagonism with the use of losartan (25 mg/d). The 2.4-fold greater LV growth in DD men may be due to the effects of angiotensin II on other receptors (eg, angiotensin type 4) or lower degradation of growth-inhibitory kinins.
S G Myerson; H E Montgomery; M Whittingham; M Jubb; M J World; S E Humphries; D J Pennell
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  103     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2004-07-08     Completed Date:  2004-07-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  226-30     Citation Subset:  AIM; IM    
Centre for Cardiovascular Genetics, University College London, London, UK.
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MeSH Terms
DNA Transposable Elements*
Gene Deletion*
Hypertrophy, Left Ventricular / drug therapy*,  etiology*
Losartan / therapeutic use*
Peptidyl-Dipeptidase A / genetics*
Polymorphism, Genetic*
Reg. No./Substance:
0/DNA Transposable Elements; 114798-26-4/Losartan; EC A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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