TY - JOUR T1 - Angiotensin-converting enzyme genotype and the ventilatory responseto exertional hypoxia JF - European Respiratory Journal JO - Eur Respir J SP - 755 LP - 760 DO - 10.1183/09031936.03.00086402 VL - 22 IS - 5 AU - S. Patel AU - D.R. Woods AU - N.J. Macleod AU - A. Brown AU - K.R. Patel AU - H.E. Montgomery AU - A.J. Peacock Y1 - 2003/11/01 UR - http://erj.ersjournals.com/content/22/5/755.abstract N2 - The “insertion” (I) rather than “deletion” (D) variant of the human angiotensin-converting enzyme (ACE) gene is associated with both lower tissue ACE activity and elite performance at high altitude. Three genotypes, II, ID and DD, are thus represented in the population. The authors examined whether an improved ventilatory response to hypoxic exercise may contribute to this effect. Subjects (n=60; 37 male, mean±sem age 23.6±0.6 yrs, 14 II, 30 ID, 16 DD) underwent incremental cardiopulmonary exercise testing to establish maximal oxygen uptake and ventilatory threshold (VT). Four hours later, subjects exercised for 6 mins at 50% of the workload at VT. The protocol was repeated 15 mins later while breathing 12.5±0.5% oxygen in nitrogen. All subject characteristics were independent of genotype, as were data during normoxic exercise. However, the hypoxia-induced rise in minute ventilation was significantly greater among those of II genotype (39.6±4.1% versus 27.9±2.0% versus 28.4±2.2% for II versus ID versus DD, respectively). These data are supported by a significantly greater decrease in end tidal carbon dioxide (consistent with an increase in alveolar ventilation) among those homozygous for the I allele (II −18.7±1.3%, ID −15.7±0.4%, DD −15.1%±1.1). The ventilatory response to hypoxic exercise is influenced by angiotensin-converting enzyme genotype. Potential implications concern high altitude performance and the pathogenesis and management of hypoxic lung disease. The funding for this study was from Dept of Respiratory Medicine research funds. H.E. Montgomery is funded by the British Heart Foundation. ER -