A1166C angiotensin II type 1 receptor gene polymorphism may predict hemodynamic response to losartan in patients with cirrhosis and portal hypertension.

SOOKOIAN SILVIA,; GARCIA , SILVIA INES; CASTAÑO, GUSTAVO; VIUDEZ, P; GONZALEZ, C; PIROLA, CARLOS JOSE

AMERICAN JOURNAL OF GASTROENTEROLOGY

Año: 2005 vol. 100 p. 636 - 642

0002-9270

Objetive:Losartan a dose of 25 mg/kg  has been found to be effective in 50% of patiens with portal hypertension without adverse effects. We evaluated the relationship between genetic polymorphism of the renin angiotensin system (A11 66AT1R, T174M and M235T and angiotensin converting enzyme  I/D) and the effect of losartan  on portal and systemic hemodynamic in patients with cirrhosis and portal hypertension. The homozygous patients for AT1R A allele showed higher pulmonary-wedged and free hepatic venous pressure on baseline. After treatment, they showed a higher decrease of HVPG in comparison with patients with AC/CC genotype (2,4%+18,9), p<0,01. Ten of 15 patiens with AA genotypewere responders, while only one of eight with AC/CC genotype (p<0,002);genotype AA showed a positive predictive value of 66,6% and negative predictive value of 87,5%. These results suggest that there is a relationship between the AT1R A1166C polymorphisms and the therapeutic response to losartan . The genetic testing may be usedas a predicted factor of this response.