Angiotensin-converting enzyme gene polymorphism is associated with vulnerability to alcoholic cardiomyopathy.

BACKGROUND

Chronic alcohol abuse has a dose-dependent toxic effect on the myocardium, leading to alcoholic cardiomyopathy. The fact that only a minority of persons with chronic alcoholism have this condition suggests the possibility of a genetic vulnerability. In this context, polymorphism of the angiotensin-converting enzyme (ACE) gene has been implicated in cardiac dysfunction.

OBJECTIVE

To compare the ACE genotypes of alcoholic persons who have cardiomyopathy with those of comparable alcohol abusers who have normal cardiac function.

DESIGN

Case-control study over a 2-year period.

SETTING

An academic tertiary referral hospital in Barcelona, Spain.

PATIENTS: 30 alcoholic men with symptomatic cardiomyopathy and 27 alcoholic men with normal cardiac function.

MEASUREMENTS: Ethanol intake, cardiac status, left ventricular ejection fraction (LVEF), and ACE gene polymorphism.

RESULTS

The DD ACE genotype was present in 57% of alcoholic persons with an LVEF less than 0.50 and in 7% of those with normal cardiac function. Compared with persons who had an I allele, the odds ratio for development of left ventricular dysfunction in alcoholic persons with the DD genotype was 16.4.

CONCLUSIONS

Vulnerability to cardiomyopathy among chronic alcohol abusers is partially genetic and is related to presence of the ACE DD genotype. This finding demonstrates genetic susceptibility to alcohol-induced myocardial damage.