Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart Disease
Rev. Soc. Bras. Med. Trop
;
53: e20190488, 2020. tab
Article
in English
| SES-SP, ColecionaSUS, LILACS
| ID: biblio-1136799
ABSTRACT
Abstract INTRODUCTION:
Chagas disease (CD) is a neglected disease caused by the parasite Trypanosoma cruzi. One-third of infected patients will develop the cardiac form, which may progress to heart failure (HF). However, the factors that determine disease progression remain unclear. Increased angiotensin II activity is a key player in the pathophysiology of HF. A functional polymorphism of the angiotensin-converting enzyme (ACE) gene is associated with plasma enzyme activity. In CD, ACE inhibitors have beneficial effects supporting the use of this treatment in chagasic cardiomyopathy.METHODS:
We evaluated the association of ACE I/D polymorphism with HF, performing a case-control study encompassing 343 patients with positive serology for CD staged as non-cardiomyopathy (stage A; 100), mild (stage B1; 144), and severe (stage C; 99) forms of Chagas heart disease. For ACE I/D genotyping by PCR, groups were compared using unconditional logistic regression analysis and adjusted for nongenetic covariates age, sex, and trypanocidal treatment.RESULTS:
A marginal, but not significant (p=0.06) higher prevalence of ACE I/D polymorphism was observed in patients in stage C compared with patients in stage A. Patients in stage C (CD with HF), were compared with patients in stages A and B1 combined into one group (CD without HF); DD genotype/D carriers were prevalent in the HF patients (OR = 2; CI = 1.013.96; p = 0.04).CONCLUSIONS:
Our results of this cohort study, comprising a population from the Northeast region of Brazil, suggest that ACE I/D polymorphism is more prevalent in the cardiac form of Chagas disease with HF.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Polymorphism, Genetic
/
Chagas Disease
/
Peptidyl-Dipeptidase A
/
Heart Failure
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Rev. Soc. Bras. Med. Trop
Year:
2020
Type:
Article
Institution/Affiliation country:
Fundação Oswaldo Cruz/BR
/
UPE+BR
/
Realcor - Real Hospital Português de Beneficência/BR
/
Universidade de São Paulo/BR
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