The Renin-Angiotensin System Gene Polymorphism and Left Ventricular Hypertrophy
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Left ventricular hypertrophy (LVH) is a major risk factor for cardiovascular morbidity and mortality, independently of blood pressure. This has been clearly demonstrated in the Framingham Study. On the other hand, inhibitors of angiotensin-converting enzyme (ACE) have been shown to have a beneficial effect on LVH. In the SOLVD trial, treatment by ACE-inhibitors was associated with a reduction of the incidence of myocardial infarction (MI) and unstable angina and of cardiovascular mortality in patients with a low ejection fraction. In the SAVE trial including post-MI patients, treatment by ACE-inhibitors was associated with a decrease of mortality and incidence of re-infarction. These results, together with the fact that angiotensin II is implicated in the modulation of cardiac growth, suggest that polymorphisms of the renin angiotensin system could play a role in the determination of left ventricular mass (LVM) and the genetic predisposition of LVH.
KeywordsLeft Ventricular Hypertrophy Left Ventricular Mass Hypertrophic Cardiomyopathy Renin Angiotensin System Idiopathic Dilate Cardiomyopathy
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