The impact of angiotensin converting enzyme gene polymorphism on the prognosis of peripartum cardiomyopathy
Abstract
Background. Peripartum cardiomyopathy (PPCM) is a rare but potentially life-threatening condition associated with heart failure after childbirth. Genetic factors, including the angiotensin-converting enzyme (ACE) gene polymorphism, may influence the course of the disease.
Materials and methods. The study included 102 patients with PPCM and 65 healthy women. Genotyping of the ACE I/D polymorphism was performed using PCR. Clinical, functional, and echocardiographic parameters were assessed.
Results. Eleven (10.8%) patients were diagnosed with functional class II, 64 (62.7%) with class III, and 27 (26.5%) with class IV. Distribution of the I/D genotypes: DD – 24 (23.5%), ID – 45 (44.1%), II – 33 (32.3%). Patients with the DD genotype had lower left ventricular ejection fraction (LVEF) and higher values for diastolic and systolic heart sizes. Over two years of observation, mortality from disease progression was 5% in the DD and ID subgroups, and 0% in the II subgroup.
Conclusion. The I/D polymorphism of the ACE gene may affect left ventricular systolic and diastolic function in patients with PPCM. Carriers of the D allele and the DD genotype have a more unfavorable prognosis.
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