Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism

ÇETİN, Mustafa; Karakişi, Ozan; Bozok, Şahin; ASLAN, Cemal; EMİR, Mustafa; DESTAN, Buğra; TÜFEKÇİ, Nebiye; İLHAN, Gökhan; KARAMUSTAFA, Hakan

Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism

Şahin BOZOK, (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Gökhan İLHAN, (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Buğra DESTAN, (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Hakan KARAMUSTAFA, (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Sedat Ozan KARAKİŞİ, (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Mustafa ÇETİN, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Rize, Türkiye)

Nebiye TÜFEKÇİ, (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Cemal ASLAN, (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Mustafa EMİR (Rize Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Rize, Türkiye)

Türk Göğüs Kalp Damar Cerrahisi Dergisi

1 1

Yıl: 2012 Cilt: 20 Sayı: 2 Sayfa Aralığı: 281 - 286 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism

Öz:

Amaç: Bu çalışmada, değişik nedenlere bağlı pulmoner tromboemboli (PTE) gelişmiş ACE geninin insersiyon/ delesyon (I/D) polimorfizmi olan hastalarda bu durum ile pulmoner arteryel basınç arasındaki ilişki araştırıldı. Çalışma planı: Çalışmaya toplam 48 hasta (23 kadın, 25 erkek; ort. yaş 60±13 yıl; dağılım 42-78 yıl) dahil edildi. Pulmoner tromboembolili hastalar ACE D allel taşıyıp taşımamalarına göre sınıflandırıldı. Grup 1 vahşi tip taşıyıcısı hastalarda oluşurken, grup 2 ACE D alleli taşıyıcısı hastalardan oluşturuldu. Bulgular: Hastaların 28’inde (%58) ACE ID (heterozigot) genotip, altısında (%13) ACE DD (homozigot) genotip mevcut idi. Kalan 14’ünde (%29) ACE genine ait delesyon alleli yok idi. Ortalama sistolik pulmoner arter basıncı (sPAP) ID genotipli hastalarda 45.7±17 mmHg, DD genotipli hastalarda 70.1±20 mmHg ve genotip II hastalarda 32.5±9 mmHg idi. ACE D allel taşıyan hastalarla taşımayanlar arasında yapılan karşılaştırmada, ACE D allel taşıyıcılığı belirgin olarak daha yüksek sPAP görüldü (32.5±8.8 karşın 50.8±20 mmHg, p=0.017). ACE D allelini taşımak (Exp(B): 7.331, p=0.032) PTE’si olan hastalarda pulmoner hipertansiyonun bağımsız göstergesi olarak bulundu. Sonuç: Sonuç olarak, ACE geninin delesyon polimorfizmi olan PTE’li olgularda pulmoner hipertansiyonun gelişme riskinin daha yüksek olduğuna inanıyoruz. Bu nedenle, ACE geninin bu hastalarda değerlendirilmesi, hastalığın etyoloji ve prognozunu aydınlatmaya katkıda bulunacaktır.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Pulmoner tromboembolide pulmoner hipertansiyon ile anjiyotensin dönüştürücü enzim geninin delesyonel polimorfizmi arasındaki bağlantı

Öz:

Background: This study aims to identify the association between pulmonary arterial pressure and insertion/deletion (I/D) polymorphism of ACE gene in the patients with pulmonary thromboembolism (PTE) due to various reasons. Methods: A total of 48 patients (23 females, 25 males; mean age 60±13 years; range 42 to 78 years) were included in the study. Patients with PTE were classified according to carrying of ACE D allele. Group 1 consisted of patients with wild type, while group 2 consisted of patients with ACE D allele carrier. Results: Tweny-eight patients (58%) had ACE ID (heterozygous) genotype, while six (13%) had ACE DD (homozygous) genotype. The remaining 14 (29%) had no deletion allele of ACE gene. The mean systolic pulmonary arterial pressure (sPAP) was 45.7±17 mmHg in patients with ID genotype, 70.1±20 mmHg in those with DD genotype, and 32.5±9 mmHg in those with II genotype. The comparison of the patients who carried ACE D allele with those who did not demonstrated that the former group had significantly higher levels of sPAP (32.5±8.8 versus 50.8±20 mmHg, p=0.017). It was found that carrying of ACE D allele (Exp(B): 7.331, p=0.032) was found to be independent predictor of pulmonary hypertension in patients with PTE. Conclusion: In conclusion, we believe that the risk for the development of pulmonary hypertension is higher especially in PTE cases with deletion polymorphism of ACE gene. Therefore, evaluation of the ACE gene in these patients will contribute to shed light into the etiology and prognosis of the disease.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Oner F, Topu Z, Celik G, Gurkan O, Atasoy C, Kucuk O, et al. Validation of a non-invasive diagnostic algorithm in assessment of patients with high pretest clinical probability of pulmonary embolism. Turkish Thoracic Journal 2004;5:26-31.
2. Castaner E, Gallardo X, Ballesteros E, Andreu M, Pallardo Y, Mata JM, et al. CT diagnosis of chronic pulmonary thromboembolism. Radiographics 2009;29:31-50.
3. Kearon C. Diagnosis of pulmonary embolism. CMAJ 2003;168:183-94.
4. Pipavath SN, Godwin JD. Acute pulmonary thromboembolism: a historical perspective. AJR Am J Roentgenol 2008;191:639-41.
5. Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, Folsom AR. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med 2002;162:1182-9.
6. Wells PS, Rodger MA, Forgie MA, Langlois NJ, Armstrong L, Carson NL, et al. The ACE D/D genotype is protective against the development of idiopathic deep vein thrombosis and pulmonary embolism. Thromb Haemost 2003;90:829-34.
7. Munhoz TP, Scheibe RM, Schmitt VM. Angiotensin converting enzyme (ACE) DD genotype: relationship with venous thrombosis. Rev Bras Hematol Hemoter 2005;27:87-90.
8. Niemiec P, Zak I, Wita K. The D allele of angiotensin I-converting enzyme gene insertion/deletion polymorphism is associated with the severity of atherosclerosis. Clin Chem Lab Med 2008;46:446-52.
9. Koutkia P, Wachtel TJ. Pulmonary embolism presenting as syncope: case report and review of the literature. Heart Lung 1999;28:342-7.
10. Wolfe TR, Allen TL. Syncope as an emergency department presentation of pulmonary embolism. J Emerg Med 1998;16:27-31.
11. Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, et al. Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 2008;29:2276-315.
12. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010;23:685-713.
13. Konstantinides S, Geibel A, Olschewski M, Kasper W, Hruska N, Jäckle S, et al. Importance of cardiac troponins I and T in risk stratification of patients with acute pulmonary embolism. Circulation 2002;106:1263-8.
14. Naeije R, Huez S. Right ventricular function in pulmonary hypertension: physiological concepts. Eur Heart J 2007;9(Suppl H):H5-9.
15. Coghlan JG, Davar J. How should we assess right ventricular function in 2008? Eur Heart J 2007;9(Suppl H):H22-8.
16. Barst RJ, McGoon M, Torbicki A, Sitbon O, Krowka MJ, Olschewski H, et al. Diagnosis and differential assessment of pulmonary arterial hypertension. J Am Coll Cardiol 2004;43:40S-47S.
17. Dilley A, Austin H, Hooper WC, Lally C, Ribeiro MJ, Wenger NK, et al. Relation of three genetic traits to venous thrombosis in an African-American population. Am J Epidemiol 1998;147:30-5.
18. Fuentes RM, Perola M, Nissinen A, Tuomilehto J. ACE gene and physical activity, blood pressure, and hypertension: a population study in Finland. J Appl Physiol 2002;92:2508-12.
19. Kreutz R, Hübner N, Ganten D, Lindpaintner K. Genetic linkage of the ACE gene to plasma angiotensin-converting enzyme activity but not to blood pressure. A quantitative trait locus confers identical complex phenotypes in human and rat hypertension. Circulation 1995;92:2381-4.
20. Abraham WT, Raynolds MV, Gottschall B, Badesch DB, Wynne KM, Groves BM, et al. Importance of angiotensinconverting enzyme in pulmonary hypertension. Cardiology 1995;86 Suppl 1:9-15.
21. Kanazawa H, Okamoto T, Hirata K, Yoshikawa J. Deletion polymorphisms in the angiotensin converting enzyme gene are associated with pulmonary hypertension evoked by exercise challenge in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000;162:1235-8.
22. Tanabe N, Amano S, Tatsumi K, Kominami S, Igarashi N, Shimura R, et al. Angiotensin-converting enzyme gene polymorphisms and prognosis in chronic thromboembolic pulmonary hypertension. Circ J 2006;70:1174-9.

APA	Bozok Ş, İLHAN G, DESTAN B, KARAMUSTAFA H, Karakişi O, ÇETİN M, TÜFEKÇİ N, ASLAN C, EMİR M (2012). Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. , 281 - 286.
Chicago	Bozok Şahin,İLHAN Gökhan,DESTAN Buğra,KARAMUSTAFA Hakan,Karakişi Ozan,ÇETİN Mustafa,TÜFEKÇİ Nebiye,ASLAN Cemal,EMİR Mustafa Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. (2012): 281 - 286.
MLA	Bozok Şahin,İLHAN Gökhan,DESTAN Buğra,KARAMUSTAFA Hakan,Karakişi Ozan,ÇETİN Mustafa,TÜFEKÇİ Nebiye,ASLAN Cemal,EMİR Mustafa Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. , 2012, ss.281 - 286.
AMA	Bozok Ş,İLHAN G,DESTAN B,KARAMUSTAFA H,Karakişi O,ÇETİN M,TÜFEKÇİ N,ASLAN C,EMİR M Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. . 2012; 281 - 286.
Vancouver	Bozok Ş,İLHAN G,DESTAN B,KARAMUSTAFA H,Karakişi O,ÇETİN M,TÜFEKÇİ N,ASLAN C,EMİR M Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. . 2012; 281 - 286.
IEEE	Bozok Ş,İLHAN G,DESTAN B,KARAMUSTAFA H,Karakişi O,ÇETİN M,TÜFEKÇİ N,ASLAN C,EMİR M "Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism." , ss.281 - 286, 2012.
ISNAD	Bozok, Şahin vd. "Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism". (2012), 281-286.

APA	Bozok Ş, İLHAN G, DESTAN B, KARAMUSTAFA H, Karakişi O, ÇETİN M, TÜFEKÇİ N, ASLAN C, EMİR M (2012). Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 20(2), 281 - 286.
Chicago	Bozok Şahin,İLHAN Gökhan,DESTAN Buğra,KARAMUSTAFA Hakan,Karakişi Ozan,ÇETİN Mustafa,TÜFEKÇİ Nebiye,ASLAN Cemal,EMİR Mustafa Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. Türk Göğüs Kalp Damar Cerrahisi Dergisi 20, no.2 (2012): 281 - 286.
MLA	Bozok Şahin,İLHAN Gökhan,DESTAN Buğra,KARAMUSTAFA Hakan,Karakişi Ozan,ÇETİN Mustafa,TÜFEKÇİ Nebiye,ASLAN Cemal,EMİR Mustafa Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.20, no.2, 2012, ss.281 - 286.
AMA	Bozok Ş,İLHAN G,DESTAN B,KARAMUSTAFA H,Karakişi O,ÇETİN M,TÜFEKÇİ N,ASLAN C,EMİR M Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2012; 20(2): 281 - 286.
Vancouver	Bozok Ş,İLHAN G,DESTAN B,KARAMUSTAFA H,Karakişi O,ÇETİN M,TÜFEKÇİ N,ASLAN C,EMİR M Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2012; 20(2): 281 - 286.
IEEE	Bozok Ş,İLHAN G,DESTAN B,KARAMUSTAFA H,Karakişi O,ÇETİN M,TÜFEKÇİ N,ASLAN C,EMİR M "Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 20, ss.281 - 286, 2012.
ISNAD	Bozok, Şahin vd. "Association between deletion polymorphism of angiotensin converting enzyme gene and pulmonary hypertension in pulmonary thromboembolism". Türk Göğüs Kalp Damar Cerrahisi Dergisi 20/2 (2012), 281-286.