New Perspectives in the Renin-Angiotensin-Aldosterone System RAAS IV: Circulating ACE2 as a Biomarker of Systolic Dysfunction in Human Hypertension and Heart FailureReport as inadecuate




New Perspectives in the Renin-Angiotensin-Aldosterone System RAAS IV: Circulating ACE2 as a Biomarker of Systolic Dysfunction in Human Hypertension and Heart Failure - Download this document for free, or read online. Document in PDF available to download.

Background

Growing evidence exists for soluble Angiotensin Converting Enzyme-2 sACE2 as a biomarker in definitive heart failure HF, but there is little information about changes in sACE2 activity in hypertension with imminent heart failure and in reverse remodeling.

Methods, Findings

Patients with systolic HF NYHAII-IV, enrolled for cardiac resynchronisation therapy, CRT, n = 100 were compared to hypertensive patients n = 239 and to a healthy cohort n = 45 with preserved ejection fraction EF>50% in a single center prospective clinical study. The status of the heart failure patients were checked before and after CRT. Biochemical ACE and sACE2 activity, ACE concentration and echocardiographic parameters EF, left ventricular end-diastolic EDD and end-systolic diameter ESD and dP-dt were measured.sACE2 activity negatively correlated with EF and positively with ESD and EDD in all patient-s populations, while it was independent in the healthy cohort. sACE2 activity was already increased in the hypertensive group, where signs for imminent heart failure slightly decreased EF and barely increased NT-proBNP levels were detected. sACE2 activities further increased in patients with definitive heart failure EF<50%, while sACE2 activities decreased with the improvement of the heart failure after CRT reverse remodeling. Serum angiotensin converting enzyme ACE concentrations were lower in the diseased populations, but did not show a strong correlation with the echocardiographic parameters.

Conclusions

Soluble ACE2 activity appears to be biomarker in heart failure, and in hypertension, where heart failure may be imminent. Our data suggest that sACE2 is involved in the pathomechanism of hypertension and HF.



Author: Katalin Úri, Miklós Fagyas, Ivetta Mányiné Siket, Attila Kertész, Zoltán Csanádi, Gábor Sándorfi, Marcell Clemens, Rolan

Source: http://plos.srce.hr/



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