ArticleHeart rhythm2014
A common angiotensin-converting enzyme polymorphism and preoperative angiotensin-converting enzyme inhibition modify risk of tachyarrhythmias after congenital heart surgery.
Article in Heart rhythm, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 16 citations in OpenAlex.
- Early Currents: Developmental Electrophysiology and Arrhythmia in Pediatric Congenital Heart Disease.Journal of cardiovascular development and disease · 2025Review
- Metabolic Response to Stress by the Immature Right Ventricle Exposed to Chronic Pressure Overload.Journal of the American Heart Association · 2019Article
- Incidence and effect of early postoperative ventricular arrhythmias after congenital heart surgery.Heart rhythm · 2019Observational
- Tell me once, tell me soon: parents' preferences for clinical genetics services for congenital heart disease.Genetics in medicine : official journal of the American College of Medical Genetics · 2018Article
- Analysis of clinical and candidate genetic risk factors for postoperative atrial tachycardia after congenital heart surgery in infants.American heart journal · 2018Article
- Heart Failure in Pediatric Patients With Congenital Heart Disease.Circulation research · 2017Review
- Genotypic and phenotypic predictors of complete heart block and recovery of conduction after surgical repair of congenital heart disease.Heart rhythm · 2017Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism is described in association with numerous phenotypes, including arrhythmias, and may provide predictive value among pediatric patients undergoing congenital heart surgery.
objectiveThe purpose of this study was to examine the role of a common polymorphism on postoperative tachyarrhythmias in a large cohort of pediatric patients undergoing congenital heart surgery with cardiopulmonary bypass (CPB).
methodsSubjects undergoing congenital heart surgery with CPB at our institution were consecutively enrolled from September 2007 to December 2012. In addition to DNA, perioperative clinical data were obtained from subjects.
resultsPostoperative tachyarrhythmias were documented in 45% of 886 enrollees and were associated with prolonged mechanical ventilation (P <.001) and intensive care unit length of stay (P <.001). ACE I/D was in Hardy-Weinberg equilibrium (19% I/I, 49% I/D, 32% D/D). I/D or D/D genotypes were independently associated with a 60% increase in odds of new tachyarrhythmia (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.1-2.3, P = .02). Preoperative ACE inhibitor administration was independently associated with a 47% reduction in odds of postoperative tachyarrhythmia in the entire cohort (OR 0.53, 95% CI 0.32-0.88, P = .01), driven by a 5-fold reduction in tachyarrhythmias among I/I genotype patients (OR 0.19, 95% CI 0.04-0.88, P = .02).
conclusionThe risk of tachyarrhythmias after congenital heart surgery is independently affected by the ACE I/D polymorphism. Preoperative ACE inhibition is associated with a lower risk of postoperative tachyarrhythmias, an antiarrhythmic effect that appears genotype dependent. An understanding of genotype variation may play an important role in the perioperative management of congenital heart surgery.
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