The effect of Angiotensin-Converting Enzyme gene variants on Heart Failure

Main Article Content

Rawaz D. Tawfeeq
Ava T. Ismael
Mohammed H. Alwan
Badraldin K. Hamad
Aram Sardar Ibrahim

Keywords

Angiotensin-converting enzyme, genetic variations, DD genotype, left ventricular hypertrophy, heart failure

Abstract

Polymorphism in the angiotensin-converting enzyme (ACE) gene has been identified as a potential contributor to the pathophysiology of heart failure (HF). Several studies have demonstrated a link between genetic variations in the ACE gene and an increased risk of HF, even in individuals with otherwise low risk factors. This review aims to examine the effect of the ACE gene Insertion-Deletion (I/D) polymorphism on the development of HF. While the ACE genetic variations do not appear to significantly contribute to the development of hypertension, they may affect the mass of the left ventricles by altering the production of angiotensin II, a potent coronary vasoconstrictor. This is evident in individuals who also have other cardiovascular conditions such as hypertension and cardiomyopathy. From a therapeutic perspective, the connection between the ACE gene and angiotensin II type-1 receptors may have clinical implications for the management and prevention of HF. Screening for genetic risk may be beneficial if drugs such as ACE inhibitors and angiotensin II receptor blockers (ARB) can counteract the effects of the ACE gene and its connection to angiotensin II type-1 receptors. The effects of angiotensin II on HF are complex, as it serves both as a cellular growth modulator and vasoactive agent, thus its impact on HF can be analysed at various stages of the disease. Future studies may confirm genotypic associations and facilitate the classification of patients into groups at risk for developing HF.

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