This Article Full Text Full Text (PDF) All Versions of this Article: 41/4/932    most recent 01.HYP.0000063146.40351.ADv1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mello, G. Articles by Fatini, C. Search for Related Content PubMed PubMed Citation Articles by Mello, G. Articles by Fatini, C. Pubmed/NCBI databases Gene GEO Profiles HomoloGene UniGene Substance via MeSH Medline Plus Health Information High Risk Pregnancy Related Collections Other hypertension

(Hypertension. 2003;41:932.)
© 2003 American Heart Association, Inc.

Scientific Contributions

Maternal-Fetal Flow, Negative Events, and Preeclampsia

Role of ACE I/D Polymorphism

Giorgio Mello; Elena Parretti; Francesca Gensini; Elena Sticchi; Federico Mecacci; Gianfranco Scarselli; Maurizio Genuardi; Rosanna Abbate; Cinzia Fatini

From the Department of Gynecology, Perinatology, and Human Reproduction (G.M., E.P., F.M., G.S., C.F.), the Department of Physiopathology (E.S., M.G.), Section of Medical Genetics, and the Department of Medical and Surgical Critical Care (R.A., C.F.), Section of Clinical Medicine and Cardiology, University of Florence, Florence, Italy.

Correspondence to Prof Rosanna Abbate, Dipartimento dell’Area Critica Medico Chirurgica, Sezione Clinica Medica Generale e Cliniche Specialistiche, University of Florence, Centro Trombosi, Azienda Ospedaliera Careggi, Viale G. Morgagni 85, 50134 Firenze, Italy. E-mail rosabbate{at}tin.it

The risk for an adverse pregnancy outcome is markedly higher in women with history of preeclampsia. This may stem from impaired placentation in early gestation and from high impedance to flow in uteroplacental circulation. The renin-angiotensin system is one of the mediators of the remodeling of spiral arteries throughout pregnancy. The D allele of the Insertion/Deletion (I/D) polymorphism in the ACE gene has been associated with higher ACE activity, accounting for 47% of the total phenotypic variance of serum enzyme levels. To investigate whether the ACE I/D polymorphism affects maternal uteroplacental and fetal umbilical circulation and the pregnancy outcome in women with a history of preeclampsia, 106 women underwent Doppler examination of uterine arteries resistance index and umbilical artery pulsatility index at the 16th, 20th, and 24th weeks of gestation and were genotyped for the I/D polymorphism. This study found a difference in genotype distribution (P=0.0002) and allele frequency (P<0.0001) between women with and those without preeclampsia recurrence and fetal growth restriction as well as an association (P=0.0007) between DD genotype and risk of recurrent preeclampsia or fetal growth restriction. At the 16th, 20th, and 24th weeks, uterine artery resistance indexes were significantly lower in II, higher in DD, and intermediate in ID genotype carriers, whereas the umbilical artery pulsatility index values were significantly higher in the DD group in comparison to ID and II genotypes. The current study shows that the ACE I/D polymorphism affects uteroplacental and umbilical flows and the recurrence of an adverse pregnancy outcome in women with history of preeclampsia.

Key Words: angiotensin-converting enzyme • polymorphism • preeclampsia • pregnancy

This article has been cited by other articles:

				C. Mando, P. Antonazzo, S. Tabano, S. Zanutto, P. Pileri, E. Somigliana, F. Colleoni, A. Martinelli, A. Zolin, C. Benedetto, et al. Angiotensin-Converting Enzyme and Adducin-1 Polymorphisms in Women With Preeclampsia and Gestational Hypertension Reproductive Sciences, September 1, 2009; 16(9): 819 - 826. [Abstract] [PDF]

				L. L Valdez-Velazquez, A. Quintero-Ramos, S. A Perez, F. Mendoza-Carrera, H. Montoya-Fuentes, F. Rivas Jr, N. Olivares, A. Celis, O. F Vazquez, and F. Rivas Genetic polymorphisms of the renin-angiotensin system in preterm delivery and premature rupture of membranes Journal of Renin-Angiotensin-Aldosterone System, December 1, 2007; 8(4): 160 - 168. [Abstract] [PDF]

				Y.-Y. Hsieh, C.-C. Chang, F.-J. Tsai, C.-M. Hsu, C.-C. Lin, and C.-H. Tsai Angiotensin I-converting enzyme ACE 2350*G and ACE-240*T-related genotypes and alleles are associated with higher susceptibility to endometriosis Mol. Hum. Reprod., January 1, 2005; 11(1): 11 - 14. [Abstract] [Full Text] [PDF]

				G. Mello, E. Parretti, C. Fatini, C. Riviello, F. Gensini, M. Marchionni, G. F. Scarselli, G. F. Gensini, and R. Abbate Low-Molecular-Weight Heparin Lowers the Recurrence Rate of Preeclampsia and Restores the Physiological Vascular Changes in Angiotensin-Converting Enzyme DD Women Hypertension, January 1, 2005; 45(1): 86 - 91. [Abstract] [Full Text] [PDF]

				E. Kajantie, A. Rautanen, J. Kere, S. Andersson, H. Yliharsila, C. Osmond, D. J. P. Barker, T. Forsen, and J. Eriksson The Effects of the ACE Gene Insertion/Deletion Polymorphism on Glucose Tolerance and Insulin Secretion in Elderly People Are Modified by Birth Weight J. Clin. Endocrinol. Metab., November 1, 2004; 89(11): 5738 - 5741. [Abstract] [Full Text] [PDF]

				R. H.P. Hilgers, P. M.H. Schiffers, W. M. Aartsen, G. E. Fazzi, J. F.M. Smits, and J. G.R. De Mey Tissue Angiotensin-Converting Enzyme in Imposed and Physiological Flow-Related Arterial Remodeling in Mice Arterioscler Thromb Vasc Biol, May 1, 2004; 24(5): 892 - 897. [Abstract] [Full Text]