Background-Local cardiac renin-angiotensin systems may regulate left ventricular (LV) hypertrophic responses. The absence (deletion [D]) of a 287-bp marker in the ACE gene is associated with greater myocardial ACE levels and exercise-related LV growth than is its presence (insertion [I]), an effect potentially mediated through either increased activity of the cellular growth factor angiotensin II on the angiotensin type 1 (AT 1 ) receptor or increased degradation of growth-inhibiting kinins. We sought to confirm ACE genotype-associated exertional LV growth and to clarify the role of the AT 1 receptor in this association. Methods and Results-One hundred forty-one British Army recruits homozygous for the ACE gene (79 DD and 62 II) were randomized to receive losartan (25 mg/d, a subhypotensive dose inhibiting tissue AT 1 receptors) or placebo throughout a 10-week physical training program. LV mass, determined by cardiac magnetic resonance, increased with training (8.4 g, PϽ0.0001 overall; 12.1 versus 4.8 g for DD versus II genotype in the placebo limb, Pϭ0.022). LV growth was similar in the losartan arm: 11.0 versus 3.7 g for DD versus II genotypes (Pϭ0.034). When indexed to lean body mass, LV growth in the II subjects was abolished, whereas it remained in the DD subjects (Ϫ0.022 versus 0.131 g/kg, respectively; Pϭ0.0009). Conclusions-ACE genotype dependence of exercise-induced LV hypertrophy is confirmed. Additionally, LV growth in DD (unlike II) subjects is in excess of the increase in lean body mass. These effects are not influenced by AT 1 receptor antagonism with the use of losartan (25 mg/d). The 2.4-fold greater LV growth in DD men may be due to the effects of angiotensin II on other receptors (eg, angiotensin type 4) or lower degradation of growth-inhibitory kinins. Key Words: hypertrophy Ⅲ myocardium Ⅲ genetics Ⅲ angiotensin Ⅲ exercise L ocal cardiac renin-angiotensin systems may regulate left ventricular (LV) hypertrophy, 1,2 which is itself associated with increased cardiovascular mortality and morbidity. 3 The absence (deletion [D]) of a 287-bp marker in the ACE gene 4 is associated with greater myocardial ACE levels 5 and exercise-related LV growth 6 than is its presence (insertion [I]), potentially through either increased activity of the cellular growth factor angiotensin II 7,8 on the angiotensin type 1 (AT 1 ) receptor 8 or increased degradation of growthinhibiting kinins. 9 We sought to confirm ACE genotype-associated exertional LV growth and to clarify the role of the AT 1 receptor in this association. Methods SubjectsHealthy normotensive white male army recruits were studied with appropriate ethics committee approval and informed consent. ACE genotype was determined (3-primer polymerase chain reaction amplification as previously described 10 ). In a prospective parallel-arm, double-blind, randomized, placebo-controlled trial, ACE gene homozygotes were randomized to receive (compliance-witnessed) 25 mg losartan or placebo daily throughout a 10-week training period. At the start and end of train...

Study Design: A randomized controlled trial. Objectives: To investigate the effectiveness of daily patella taping and exercise on pain and function in individuals with patellofemoral pain syndrome. Background: Patella taping and muscle-strengthening programs are commonly used to treat patellofemoral pain syndrome. There is, however, little evidence for the effectiveness of these approaches. Methods and Measures: Twenty-four men and 6 women aged 17 to 25 years (mean ± SD, 18.7 ± 1.2 years) participated in the study. Subjects were randomly and exclusively assigned to 1 of 3 treatment groups: patella taping combined with a standardized exercise program, placebo patella taping and exercise program, or exercise program alone (n = 10 in each group). Taping was applied and exercises performed on a daily basis for 4 weeks. Outcome measures were visual analog scales for pain and the functional index questionnaire, recorded at weekly intervals by a therapist who was blinded to group allocation. Results: Separate mixed-model ANOVAs, with repeated measures on time, indicated statistically significant improvements in pain and function over time for all groups (P Ͻ.01) and also significant differences between groups for all measures (P Ͻ.01). Separate independent samples t tests showed that the group receiving taping and exercises had better pain and function scores following treatment than the placebo taping-and-exercise group and the exercise-alone group. There were no significant differences between the placebo taping-and-exercise group and exercise-alone group at any time point. Conclusions: These findings indicate that over a period of 4 weeks a combination of daily patella taping and exercises was successful in improving pain and function in individuals with patellofemoral pain syndrome. The combination of patella taping and exercise was superior to the use of exercise alone.