アンジオテンシン変換酵素の遺伝子型は,静脈性安定性心不全の治療を受けた患者の肺機能と運動能力を調節する
M Roselle Abraham1, Lyle J Olson, Michael J Joyner
1Division of Cardiovascular, Mayo Clinic and Foundation, Rochester, Minn 55905, USA.
Circulation
|October 3, 2002
まとめ
アンジオテンシン変換酵素 (ACE) DD遺伝子型は,閉塞性心不全 (CHF) 患者における運動耐性の低下と関連しています. これは肺機能障害によるものかもしれないので,ACEを標的として抑制することで運動能力を向上させることが考えられます.
科学分野:
- 心臓病学 心臓病学
- 遺伝学 遺伝学とは
- 肺医学 肺医学について
背景:
- アンジオテンシン変換酵素 (ACE) 遺伝子ポリモルフィズムは,ACE活性と血管活性物質に影響を与えます.
- 肺機能障害は,閉塞性心不全 (CHF) で一般的ですが,そのメカニズムは完全に理解されていません.
- ACE阻害は,CHF患者のガス交換と運動能力を改善することができます.
研究 の 目的:
- 治療中のCHF患者におけるACE遺伝子型と肺機能の関連性を調査する.
- ACE遺伝子型がCHFにおける運動不耐性と相関するかどうかを判断する.
主な方法:
- ACE遺伝子型 (DD,ID,II) によって層格化した57人のCHF患者を研究した.
- 評価された肺機能,左心室排出分数 (LVEF),ACE活性,およびプラズマアンジオテンシンII.
- 段階的な運動中に評価されたピーク酸素消費量 (VO2) とガス交換.
主要な成果:
- LVEF,腹動脈機能,または肺動脈圧の遺伝子型間の有意な差異はありません.
- ACEDD遺伝子型は,ピークVO2と強制生命能力の有意な低下と関連していました.
- DDホモジゴーテは,運動中に血清ACE活性,血アンジオテンシンII,および呼吸器における二酸化炭素 (VE/VCO2) に相当する濃度が高いことを示した.
結論:
- ACEDD遺伝子型は,潜在的に肺機能の変化を通じて,CHFにおける運動耐性の低下と関連しています.
- より完全なACE阻害またはブラジキニンの増強のための戦略は,DD遺伝子型のCHF患者の運動能力を高める可能性があります.
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