CLINICAL STUDIES
Angiotensinogen gene M235T polymorphism predicts left ventricular hypertrophy in endurance athletes
Jouko Karjalainen, MD*,
Urho M. Kujala, MD ,
Anu Stolt, MD,
Matti Mäntysaari, MD*,
Matti Viitasalo, MD ,
Katariina Kainulainen, MD and
Kimmo Kontula, MD
* Central Military Hospital, Helsinki, Finland
Unit for Sports and Exercise Medicine, Institute of Biomedicine, University of Helsinki, Helsinki, Finland
Department of Medicine, University of Helsinki, Helsinki, Finland
Manuscript received December 22, 1998;
revised manuscript received March 2, 1999,
accepted April 9, 1999.
Reprint requests and correspondence: Dr. Jouko Karjalainen, Central Military Hospital, Box 50, 00301 Helsinki, Finland
jouko.karjalainen{at}pp.inet.fi
OBJECTIVES
We studied whether left ventricular mass in athletes associates with polymorphisms in genes encoding components of the renin–angiotensin system.
BACKGROUND
Adaptive left ventricular hypertrophy is a feature of the athlete’s heart. However, similarly training athletes develop left ventricular mass to a different extent, suggesting that genetic factors may modulate heart size.
METHODS
We measured left ventricular mass by echocardiography in 50 male and 30 female elite endurance athletes aged 25 ± 4 (mean ± SD) years. Deoxyribonucleic acid samples were prepared for genotyping of angiotensinogen (AGT) gene M235T polymorphism, angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and angiotensin II type 1 receptor (AT1) gene A1166C polymorphism.
RESULTS
The AGT gene M235T genotypes were significantly associated with left ventricular mass independently of blood pressure in both genders (p = 0.0036 for pooled data). TT homozygotes had greater mass compared with MM homozygotes in both men (147 ± 12 g/m vs. 132 ± 15 g/m, p = 0.032) and women (121 ± 12 g/m vs. 101 ± 13 g/m, p = 0.019). There was a gender difference in the relation between myocardial mass and AGT genotype, MT heterozygotes resembling MM homozygotes among women and TT homozygotes among men. The other studied gene polymorphisms were not associated with left ventricular mass.
CONCLUSIONS
Angiotensinogen gene M235T polymorphism is associated with the variability in left ventricular hypertrophy induced by endurance training, with athletes homozygous for the T allele having the largest hearts. We found no association between ACE gene I/D or AT1 gene A1166C polymorphisms and left ventricular mass.
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Abbreviations and Acronyms
| | ACE | = angiotensin-converting enzyme | | AGT | = angiotensinogen | | ANCOVA | = analysis of covariance | | AT1 | = angiotensin II type 1 receptor | | I/D | = insertion/deletion | | LV | = left ventricular | | PCR | = polymerase chain reaction | | RAS | = renin–angiotensin system |
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