The relationship of ACE gene polymorphism in hronic hemodialysis patients with QT dispersion

Cardiovascular diseases especially ventricular arrhythmias are the leading cause of morbidity and mortality in patients with end stage renal disease. QT dispersion is a non-invasive measurement of ventricular repolarisation inhomogeneity and an important predictor of ventricular arrhythmias. Polymorphism of ACE gene is correlated with a variety of cardiovascular diseases. The ACE D allele is known to increase the risk of developing malignant ventricular arrhythmias and is also associated with increased QT dispersion in patients after myocardial infarction and essential hypertension. The aim of present study was to evaluate the relationship of ACE gene polymorphism and QT dispersion in chronic hemodialysis patients.In 70 chronic hemodialysis patients the electrocardiography was performed and QT dispersion was calculated. QTc interval was calculated by using Bazett?s Formula. ACE gene polymorphism was performed by PCR.The mean age of the patients consisting of 33 women and 37 men was 60±12 years. ACE II, ID and DD genotypes were identified in 10, 41 and 19 patients, respectively. The mean QTd and QTc dispersion (QTcd) were 61.71±21.99 and 73.18±25.51 respectively. QTd had inverse correlation with calcium and potassium and positive correlation with ACE gene polymorphism and residual urine. Ca was the predictor factor for QTd. The ACE genotype had positive correlations with QTd, QTcd, hemoglobin and residual urine and inverse correlation with potassıum. QTcd had positive correlations with ACE gene polymorphism and residual urine. When QTd and QTcd subgroups related with ACE II,ID,DD genotypes, DD genotypes had significally higher QTd and QTcd than II, ID genotypes..Our present study differs from other related studies in that it shows that the most important parameter effecting QTcd is ACE gene polymorphism on the background of D allelle and patients carrying this allelle deserves special attention regarding maximal suppression of renin-angiotensin-aldosteron system activity .