Relationship Between Angiotensin-Converting Enzyme Gene Polymorphism and Severity of Aortic Valve Calcification.

OBJECTIVE: To investigate the role of anglotensin-converting enzyme (ACE) gene polymorphism in patients with degenerative aortic valve calcification (AVC). PATIENTS AND METHODS: Our study consisted of 305 Turkish patients of European descent (139 male, 166 female; mean ± age, 68±9 years) referred to our echocardiography laboratory for aortic valve evaluation between June 2, 2003, and April 29, 2005. The severity of AVC was graded from I to 6 by echocardiography. We used polymerase chain reaction to determine ACE gene polymorphism. RESULTS: The ACE insertion/deletion genotype distributions for the study population were in Hardy-Weinberg equilibrium (X2=3.5, P=.18). The study population was divided into 3 groups based on the severity of AVC: those with grade I calcification were in group 1, those with grades 2 to 4 in group 2, and those with grades 5 to 6 in group 3. Group I patients were significantly younger, less likely to have hypertension and diabetes, and had higher high-density lipoprotein cholesterol levels. The genotype frequencies were significantly different among groups, with the insertion/insertion genotype being less prevalent in group 3 patients. In multivariate analysis, independent predictors of severe AVC were hypertension (odds ratio [OR], 5.6; 95% confidence interval [Cl], 2.8-11.0; P<.001), low high-density lipoprotein cholesterol (OR, 2.7; 95% Cl, 1.5-4.9; P=.001), and the deletion/deletion and insertion/deletion vs insertion/insertion genotype (OR, 3.2; 95% Cl, 1.5-7.2; P=.0O4). CONCLUSION: These results suggest that ACE gene polymorphism may be associated with severe AVC. [ABSTRACT FROM AUTHOR]