Polimorfismo genético, terapia farmacológica e função cardíaca seqüencial em pacientes com insuficiência cardíaca

Cuoco, Marco Antonio Romeo; Pereira, Alexandre C.; Mota, Glória de Fátima Alves da; Mansur, Alfredo José

doi:10.1590/s0066-782x2008000400007

Cited by 12 publications

(10 citation statements)

References 16 publications

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“…Other studies support the thesis that drug treatment with ACE inhibitors 18 or with beta-blockers 12 has a more positive influence on the echocardiographic parameters of DD genotype patients. The Russian study 18 assessing patients with ischemic heart failure has reported greater improvement in ejection fraction and systolic and diastolic diameters in the DD genotype patients who started treatment with perindopril.…”

Section: Discussionmentioning

confidence: 71%

“…12 Nagashima et al 13 have shown, in patients with old anteroseptal infarction, the higher influence of DD and DI genotypes on left ventricular remodeling as compared with that of II genotype patients. In addition, He et al 14 have reported that the I/D ACEGP can have an important role in late ventricular remodeling after acute myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

“…Such results are in accordance with literature reports of higher severity of those patients and worse echocardiographic outcome. 5,12 …”

Section: Discussionmentioning

confidence: 99%

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Influence of Angiotensin-Converting-Enzyme Gene Polymorphism on Echocardiographic Data of Patients with Ischemic Heart Failure

Duque¹,

Silva²,

Albuquerque³

et al. 2016

Arquivos Brasileiros De Cardiologia

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BackgroundAssociation between angiotensin-converting-enzyme (ACE) gene polymorphisms and different clinical and echocardiographic outcomes has been described in patients with heart failure (HF) and coronary artery disease. Studying the genetic profile of the local population with both diseases is necessary to assess the occurrence of that association.ObjectivesTo assess the frequency of ACE gene polymorphisms in patients with ischemic HF in a Rio de Janeiro population, as well as its association with echocardiographic findings.MethodsGenetic assessment of I/D ACE polymorphism in association with clinical, laboratory and echocardiographic analysis of 99 patients.ResultsThe allele frequency was: 53 I alleles, and 145 D alleles. Genotype frequencies were: 49.5% DD; 47.48% DI; 3.02% II. Drug treatment was optimized: 98% on beta-blockers, and 84.8% on ACE inhibitors or angiotensin-receptor blocker. Echocardiographic findings: difference between left ventricular diastolic diameters (ΔLVDD) during follow-up: 2.98±8.94 (DD) vs. 0.68±8.12 (DI) vs. -11.0±7.00 (II), p=0.018; worsening during follow-up of the LV systolic diameter (LVSD): 65.3% DD vs. 19.0% DI vs. 0.0% II, p=0.01; of the LV diastolic diameter (LVDD): 65.3% DD vs. 46.8% DI vs. 0.0% II, p=0.03; and of the LV ejection fraction (LVEF): 67.3% DD vs. 40.4% DI vs. 33.3% II, p=0.024. Correlated with D allele: ΔLVEF, ΔLVSD, ΔLVDD.ConclusionsMore DD genotype patients had worsening of the LVEF, LVSD and LVDD, followed by DI genotype patients, while II genotype patients had the best outcome. The same pattern was observed for ΔLVDD.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

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Influence of Angiotensin-Converting-Enzyme Gene Polymorphism on Echocardiographic Data of Patients with Ischemic Heart Failure

Duque¹,

Silva²,

Albuquerque³

et al. 2016

Arquivos Brasileiros De Cardiologia

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“…Cuoco et al showed in a population of heart failure patients (90% receiving ACE inhibitors) that carriers of the D allele had significantly improved LVEF compared to wild-type patients after a mean follow-up of ~39 months. 66 In contrast, in a population of patients with left ventricular hypertrophy and hypertension receiving ACE inhibitors, patients with the D/D genotype had less improvement in hypertrophy. 67 In a third study, the presence of the D allele had no impact on mortality in diastolic heart failure patients who received ACE inhibitors.…”

Section: Drugs Targeting the Renin-angiotensin-aldosterone Systemmentioning

confidence: 98%

Pharmacogenomics in Heart Failure

Oni‐Orisan

Lanfear

2014

Cardiology in Review

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Heart failure is becoming increasingly prevalent in the United States and is a significant cause of morbidity and mortality. Several therapies are currently available to treat this chronic illness; however, clinical response to these treatment options exhibit significant interpatient variation. It is now clearly understood that genetics is a key contributor to diversity in therapeutic response, and evidence that genetic polymorphisms alter the pharmacokinetics, pharmacodynamics, and clinical response of heart failure drugs continues to accumulate. This suggests that pharmacogenomics has the potential to help clinicians improve the management of heart failure by choosing the safest and most effective medications and doses. Unfortunately, despite much supportive data, pharmacogenetic optimization of heart failure treatment regimens is not yet a reality. In order to attenuate the rising burden of heart failure, particularly in the context of the recent paucity of new effective interventions, there is an urgent need to extend pharmacogenetic knowledge and leverage these associations in order to enhance the effectiveness of existing heart failure therapies. The present review focuses on the current state of pharmacogenomics in heart failure and provides a glimpse of the aforementioned future needs.

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“…The deletion results in significantly higher ACE levels [38]; therefore it was postulated that HF patients possessing the deletion would require a higher dose of ACE inhibitor to achieve the same inhibition. Most of the clinical pharmacogenetic studies are consistent with the functional effects, with respect to mean arterial pressure [39], aldosterone escape [40], serum ACE activity [41], and survival [42], but the association with LVEF is less clear [43,44]. …”

Section: Ace Inhibitor Pharmacogenetics: Background (Literature Priormentioning

confidence: 99%

Pharmacogenetics in Chronic Heart Failure: New Developments and Current Challenges

Talameh

Lanfear

2011

Curr Heart Fail Rep

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The individual patient responses to chronic heart failure (HF) pharmacotherapies are highly variable. This variability cannot be entirely explained by clinical characteristics, and genetic variation may play a role. Therefore the purpose of this review is to 1) summarize the background pharmacogenetic literature for major HF pharmacotherapy classes (i.e. beta-blockers, angiotensin converting enzyme inhibitors, digoxin, and loop diuretics), 2) evaluate recent advances in the HF pharmacogenetic literature in the context of previous findings, and 3) discuss the challenges and conclusions for HF pharmacogenetic data and its clinical application.

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Polimorfismo genético, terapia farmacológica e função cardíaca seqüencial em pacientes com insuficiência cardíaca

Abstract: SummaryBackground: Functional variants of angiotensin-converting enzyme (ACE) gene may be associated with response to therapy in patients with heart failure (HF).

Cited by 12 publications

References 16 publications

Influence of Angiotensin-Converting-Enzyme Gene Polymorphism on Echocardiographic Data of Patients with Ischemic Heart Failure

Influence of Angiotensin-Converting-Enzyme Gene Polymorphism on Echocardiographic Data of Patients with Ischemic Heart Failure

Pharmacogenomics in Heart Failure

Pharmacogenetics in Chronic Heart Failure: New Developments and Current Challenges

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