IJCS | Volume 32, Nº1, January/ February 2019

56 Figura 1 - Localization of the angiotensin converting enzyme (ACE) gene. Silva et al. ACE polymorphism and echocardiographic data in HF Int J Cardiovasc Sci. 2019;32(1)55-60 Original Article In this context, analysis of genetic polymorphisms is a non-invasive technique that may open new avenues and indicate potential preventive therapies for these patients. Angiotensin converting enzyme (ACE) gene is located on chromosome 17q23 and consists of 24 introns. 9 Several approaches on ACE polymorphism in HF have been reported in the literature, including three clinical trials that did not find an association between ACE polymorphismandHF. 4,10,11 Other studies, however, have suggested the DD phenotype as a risk factor for cardiac hypertrophy and HF 12 and associated this phenotype with worse survival. 13 Figure 1 shows the localization of the gene that encodes ACE. 14 In the last years, ACE polymorphism has drawn much attention due to conflicting results of the studies on HF. The present study aimed to identify ACE gene D/I (deletion/insertion) in patientswithHF caused byChagas disease and compare it with echocardiographic results. Methods This was an observational cohort study. Clinical data were collected from the medical records of patients seen at the Cardiology Unit of the Federal University of Goias, Brazil. Genetic analysis was performed at the Laboratory of Genetics andMolecular Cardiology (Incor/University of Sao Paulo, Brazil). One hundred and three patients were evaluated from February 2014 to October 2015. All patients were on optimized drug therapy according to current guidelines. 8 All patients included in the study underwent complete genotyping process for I/D alleles. Alleles were determined after the patients were included in the study. All clinical data were extracted from medical records by the first author of this article, before patients’ visits, and ten patients were invited to participate in the study. Inclusion criteria were age older than 18 years, diagnosis of HF as established by the Framingham criteria, and doppler echocardiography using the Teichholz method (more recent and available tests were considered for analysis). Exclusion criteria were: unavailable or inadequate medical records, and HF caused by other than Chagas disease. The study was analyzed and approved by the Ethics Committee of the General Hospital of the Federal University of Goias (approval number 908.870). All patients signed an informed consent form, and the study was conducted according to current ethical issues. Echocardiographic variables All patients had echocardiography results available in the medical records. The following echocardiographic parameters were evaluated (Table 1) – LAV: left atrial volume; EF: ejection fraction; LVDD: left ventricular diastolic diameter; LVSD: left ventricular systolic diameter (Teichholz method). Echocardiographic measures of cavity diameter and muscle thickness were obtained following the American Echocardiography Society recommendations. 15