Key result
Optimal AHF therapy linked to normalized ACE2 and Ang 1-7 levels by 3 months.
Why the study?
The role of the ACE2/Ang-(1-7)/Mas receptor axis in heart failure required clarification, and serial changes in ACE2 and Ang-(1-7) after optimal therapy in acute heart failure had not been reported.
Does optimal therapy normalize serum ACE2 and Ang-(1-7) concentrations in patients with acute heart failure with reduced ejection fraction compared to healthy individuals?
Observational (n=68)
Does optimal therapy normalize serum ACE2 and Ang-(1-7) concentrations in patients with acute heart failure with reduced ejection fraction compared to healthy individuals?
Optimal therapy for acute heart failure with reduced ejection fraction normalizes serum ACE2 and Ang-(1-7) concentrations within 3 months.
Optimal therapy may restore RAS balance in acute HFrEF; leaves open whether this improves outcomes or warrants targeted interventions.
OBJECTIVE: Elucidation of the role of angiotensin-converting enzyme (ACE) 2 (ACE2)/angiotensin (Ang)-(1-7)/Mas receptor axis in heart failure is necessary. No previous study has reported serial changes in ACE2 and Ang-(1-7) concentrations after optimal therapy (OT) in acute heart failure (AHF) patients. We aimed to investigate serial changes in serum ACE2 and Ang-(1-7) concentrations after OT in AHF patients with reduced ejection fraction (EF). METHODS: ACE2 and Ang-(1-7) concentrations were measured in 68 AHF patients with reduced EF immediately after admission and 1 and 3 months after OT. These parameters were compared with the healthy individuals at three time points. RESULTS: In the acute phase, Ang-(1-7) and ACE2 concentrations was statistically significantly lower and higher in AHF patients than the healthy individuals (2.40 ± 1.11 vs. 3.1 ± 1.1 ng/ml, P<0.005 and 7.45 ± 3.13 vs. 4.84 ± 2.25 ng/ml, P<0.005), respectively. At 1 month after OT, Ang-(1-7) concentration remained lower in AHF patients than the healthy individuals (2.37 ± 1.63 vs. 3.1 ± 1.1 ng/ml, P<0.05); however, there was no statistically significant difference in ACE2 concentration between AHF patients and the healthy individuals. At 3 months after OT, there were no statistically significant differences in Ang-(1-7) and ACE2 concentrations between AHF patients and the healthy individuals. CONCLUSION: ACE2 concentration was equivalent between AHF patients and the healthy individuals at 1 and 3 months after OT, and Ang-(1-7) concentration was equivalent at 3 months after OT.
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Hisatake et al. (2020) conducted an observational in Acute decompensated heart failure with reduced ejection fraction (n=68). Optimal therapy vs. Healthy individuals was evaluated on Serial changes in serum ACE2 and Ang-(1-7) concentrations (p=<0.005). Optimal therapy for acute heart failure normalized initially depressed Ang-(1-7) (2.40 vs 3.1 ng/ml, P<0.005) and elevated ACE2 (7.45 vs 4.84 ng/ml, P<0.005) to healthy control levels by 3 months.
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