Functional polymorphisms in ACE and CYP11B2 genes and atrial fibrillation in patients with hypertensive heart disease.

BACKGROUND: The activated renin-angiotensin-aldosterone system has been reported to play an important role in the pathogenesis of atrial fibrillation (AF). We hypothesized that functional genetic variations of angiotensin-converting enzyme (ACE) and CYP11B2 genes may influence the susceptibility to AF in patients with hypertensive heart disease. METHODS: The I/D polymorphism of ACE was detected by polymerase chain reaction (PCR), and the -344C/T polymorphism of the CYP11B2 gene was detected using PCR and subsequent cleavage by HaeIII restriction endonuclease. RESULTS: The overall distribution of ACE I/D genotypes in patients with and without AF was significantly different (p=0.001). The frequency of the DD genotype was significantly higher in patients with AF than in patients without AF (20.6% vs. 8.1%, OR 2.94, 95% CI 1.64-5.26, p<0.001). The frequency of the D allele was significantly higher in the AF group than in the non-AF group (p=0.001). After adjustment for age and left atrial dimension, multivariable analysis showed that the DD genotype of the ACE gene was an independent risk factor for AF in patients with hypertensive heart disease. No relationship between -344 C/T CYP11B2 polymorphism and AF was found in this cohort. CONCLUSIONS: Our study suggests that ACE I/D polymorphism is associated with AF and the DD genotype may be an independent predictive factor for AF in patients with hypertensive heart disease.