Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography
Abstract Background This study explores the relationship between angiotensin-converting enzyme (ACE) gene polymorphisms and early diastolic dysfunction in patients with hypertension utilizing four-dimensional echocardiography and assesses the prognosis. Methods This study consecutively selected 470...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
|
| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-025-04498-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850067584434569216 |
|---|---|
| author | Xinyu Cheng Zhiyi Zong Xiaofei Mei Yufeng Jiang Jinsheng Shen Hezi Jiang Hui Xu Yafeng Zhou |
| author_facet | Xinyu Cheng Zhiyi Zong Xiaofei Mei Yufeng Jiang Jinsheng Shen Hezi Jiang Hui Xu Yafeng Zhou |
| author_sort | Xinyu Cheng |
| collection | DOAJ |
| description | Abstract Background This study explores the relationship between angiotensin-converting enzyme (ACE) gene polymorphisms and early diastolic dysfunction in patients with hypertension utilizing four-dimensional echocardiography and assesses the prognosis. Methods This study consecutively selected 470 patients with hypertension who visited the Fourth Affiliated Hospital of Soochow University between September 2021 and August 2022, with 274 meeting the inclusion criteria. Hypertension gene testing was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) techniques, and the Hardy–Weinberg equilibrium test was used to confirm genetic equilibrium. Patients were categorized into the D allele group (n = 163) and the non-D allele group (n = 111). Diastolic function was assessed using four-dimensional echocardiography, which included averaging the E/e’ ratio over three cardiac cycles, measuring the left atrial (LA) maximum volume index (LA volume), tricuspid regurgitation velocity (TR velocity), LA strain, and left ventricular isovolumic relaxation time (IVRT). Patients were subsequently classified into the diastolic dysfunction group (n = 133) and the normal diastolic function group (n = 141). Chi-square tests were used to analyze differences in diastolic function indicators between the groups, Logistic regression was applied to control for potential confounding factors, and receiver operating characteristic (ROC) curves were plotted to assess the predictive value of different ACE alleles for diastolic dysfunction in patients with hypertension. Results The genotype distribution in both the D allele group and the non-D allele group was consistent with Hardy–Weinberg equilibrium (P > 0.05). Compared to the non-D allele group, echocardiographic indicators in the D allele group showed a decline in diastolic function: the average E/e' ratio over three cardiac cycles (14.67 [13.82, 15.80] vs. 9.30 [8.12, 12.00]), LA volume (32.76 [29.34, 34.61] vs. 25.61 [22.63, 29.64] ml/m2), TR velocity (2.90 [2.40, 2.90] vs. 1.40 [1.10, 2.40] cm/s), LA strain (18.00 [14.00, 25.00] vs. 37.00 [24.00, 40.00] %), and IVRT (104.25 [95.87, 106.25] vs. 88.09 [80.99, 96.56] ms). Differences between each group were statistically significant (all P < 0.05). The number of patients with diastolic dysfunction was higher in the D allele group (n = 102; 62.6%) compared to the non-D allele group (n = 31; 27.9%). In the logistic regression model, the D allele was associated with an increased risk of early diastolic dysfunction in hypertension (OR = 4.32, 95% CI = 2.56–7.27, P < 0.01). In the adjusted model, the D allele remained associated with an elevated risk of early diastolic dysfunction in hypertension (OR = 3.83, 95% CI = 2.24–6.54, P < 0.01). ROC curve analysis indicated that the D allele has predictive value for early diastolic dysfunction in patients with hypertension (area under the curve [AUC], 0.667; 95% confidence interval [CI], 0.608–0.723; sensitivity, 76.7%; and specificity, 56.7%; P < 0.05). Conclusions The ACE-D allele is associated with early diastolic dysfunction in hypertension. ACE gene testing can enhance the predictive value for diastolic dysfunction in patients with hypertension. |
| format | Article |
| id | doaj-art-b9bb06229c0b408ebb82769250013dc2 |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-b9bb06229c0b408ebb82769250013dc22025-08-20T02:48:16ZengBMCBMC Cardiovascular Disorders1471-22612025-02-0125111410.1186/s12872-025-04498-xExploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiographyXinyu Cheng0Zhiyi Zong1Xiaofei Mei2Yufeng Jiang3Jinsheng Shen4Hezi Jiang5Hui Xu6Yafeng Zhou7Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake HospitalDepartment of Neurology, the Second Affiliated Hospital of Soochow UniversityDepartment of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake HospitalDepartment of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake HospitalDepartment of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake HospitalDepartment of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake HospitalDepartment of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake HospitalDepartment of Cardiology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake HospitalAbstract Background This study explores the relationship between angiotensin-converting enzyme (ACE) gene polymorphisms and early diastolic dysfunction in patients with hypertension utilizing four-dimensional echocardiography and assesses the prognosis. Methods This study consecutively selected 470 patients with hypertension who visited the Fourth Affiliated Hospital of Soochow University between September 2021 and August 2022, with 274 meeting the inclusion criteria. Hypertension gene testing was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP) techniques, and the Hardy–Weinberg equilibrium test was used to confirm genetic equilibrium. Patients were categorized into the D allele group (n = 163) and the non-D allele group (n = 111). Diastolic function was assessed using four-dimensional echocardiography, which included averaging the E/e’ ratio over three cardiac cycles, measuring the left atrial (LA) maximum volume index (LA volume), tricuspid regurgitation velocity (TR velocity), LA strain, and left ventricular isovolumic relaxation time (IVRT). Patients were subsequently classified into the diastolic dysfunction group (n = 133) and the normal diastolic function group (n = 141). Chi-square tests were used to analyze differences in diastolic function indicators between the groups, Logistic regression was applied to control for potential confounding factors, and receiver operating characteristic (ROC) curves were plotted to assess the predictive value of different ACE alleles for diastolic dysfunction in patients with hypertension. Results The genotype distribution in both the D allele group and the non-D allele group was consistent with Hardy–Weinberg equilibrium (P > 0.05). Compared to the non-D allele group, echocardiographic indicators in the D allele group showed a decline in diastolic function: the average E/e' ratio over three cardiac cycles (14.67 [13.82, 15.80] vs. 9.30 [8.12, 12.00]), LA volume (32.76 [29.34, 34.61] vs. 25.61 [22.63, 29.64] ml/m2), TR velocity (2.90 [2.40, 2.90] vs. 1.40 [1.10, 2.40] cm/s), LA strain (18.00 [14.00, 25.00] vs. 37.00 [24.00, 40.00] %), and IVRT (104.25 [95.87, 106.25] vs. 88.09 [80.99, 96.56] ms). Differences between each group were statistically significant (all P < 0.05). The number of patients with diastolic dysfunction was higher in the D allele group (n = 102; 62.6%) compared to the non-D allele group (n = 31; 27.9%). In the logistic regression model, the D allele was associated with an increased risk of early diastolic dysfunction in hypertension (OR = 4.32, 95% CI = 2.56–7.27, P < 0.01). In the adjusted model, the D allele remained associated with an elevated risk of early diastolic dysfunction in hypertension (OR = 3.83, 95% CI = 2.24–6.54, P < 0.01). ROC curve analysis indicated that the D allele has predictive value for early diastolic dysfunction in patients with hypertension (area under the curve [AUC], 0.667; 95% confidence interval [CI], 0.608–0.723; sensitivity, 76.7%; and specificity, 56.7%; P < 0.05). Conclusions The ACE-D allele is associated with early diastolic dysfunction in hypertension. ACE gene testing can enhance the predictive value for diastolic dysfunction in patients with hypertension.https://doi.org/10.1186/s12872-025-04498-xFour-dimensional echocardiographyHypertensionDiastolic dysfunctionACE gene polymorphismsGenetic equilibrium |
| spellingShingle | Xinyu Cheng Zhiyi Zong Xiaofei Mei Yufeng Jiang Jinsheng Shen Hezi Jiang Hui Xu Yafeng Zhou Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography BMC Cardiovascular Disorders Four-dimensional echocardiography Hypertension Diastolic dysfunction ACE gene polymorphisms Genetic equilibrium |
| title | Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography |
| title_full | Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography |
| title_fullStr | Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography |
| title_full_unstemmed | Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography |
| title_short | Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography |
| title_sort | exploring the impact of angiotensin converting enzyme ace gene polymorphism on early diastolic function in hypertension using four dimensional echocardiography |
| topic | Four-dimensional echocardiography Hypertension Diastolic dysfunction ACE gene polymorphisms Genetic equilibrium |
| url | https://doi.org/10.1186/s12872-025-04498-x |
| work_keys_str_mv | AT xinyucheng exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography AT zhiyizong exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography AT xiaofeimei exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography AT yufengjiang exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography AT jinshengshen exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography AT hezijiang exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography AT huixu exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography AT yafengzhou exploringtheimpactofangiotensinconvertingenzymeacegenepolymorphismonearlydiastolicfunctioninhypertensionusingfourdimensionalechocardiography |