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Influence of Angiotensin-converting Enzyme Insertion/Deletion Gene Polymorphism in Progression of Chagas Heart

Silvia Marinho Martins Alves1, Lúcia Elena Alvarado-Arnês2, Maria da Glória Aureliano de Melo Cavalcanti3

  • 1Hospital das Clínicas HCFMUSP, Instituto do Coração (InCor), Universidade de São Paulo, São Paulo, SP, Brasil.

Revista Da Sociedade Brasileira De Medicina Tropical
|July 9, 2020
PubMed

Insights

The angiotensin-converting enzyme (ACE) I/D polymorphism is more common in patients with Chagas disease (CD) who develop heart failure (HF). This genetic factor may influence disease progression in Chagas cardiomyopathy.

Area of Science:

  • Genetics and Genomics
  • Cardiovascular Disease
  • Infectious Diseases

Background:

  • Chagas disease (CD) is a parasitic infection with potential cardiac complications.
  • Chagas heart disease (CHD) can progress to heart failure (HF).
  • Factors influencing CHD progression, particularly to HF, require further elucidation.

Purpose of the Study:

  • To investigate the association between the angiotensin-converting enzyme (ACE) I/D polymorphism and the development of heart failure in Chagas disease.
  • To identify potential genetic markers for disease progression in Chagas cardiomyopathy.

Main Methods:

  • A case-control study was conducted with 343 patients diagnosed with CD.
  • Patients were categorized into non-cardiomyopathy (stage A), mild (stage B1), and severe (stage C) forms of CHD.
  • ACE I/D genotyping was performed using PCR, with statistical analysis adjusted for non-genetic factors.

Main Results:

  • A higher prevalence of the ACE I/D polymorphism was observed in patients with severe CHD (stage C) compared to those with non-cardiomyopathy (stage A), though not statistically significant (p=0.06).
  • The DD genotype or D allele carriers were significantly more prevalent in patients with heart failure (stage C) compared to those without HF (stages A and B1 combined) (OR = 2; p = 0.04).

Conclusions:

  • The ACE I/D polymorphism appears to be more prevalent in the cardiac form of Chagas disease associated with heart failure.
  • This genetic variation may serve as a potential indicator for the progression of Chagas heart disease towards heart failure.
Abstract

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