Key result
Combined treatment with spontaneous physical activity and perindopril significantly increased the plasma Ang-(1-7)/Ang II ratio to 11.19 compared to 0.34 in sedentary controls in mice with advanced heart failure, though it did not improve cardiac function.
Why the study?
It was unclear whether physical activity and ACE inhibition could synergistically modulate the ACE/ACE-2 balance during heart failure.
Does combined physical activity and ACE inhibition improve ACE/ACE-2 balance and cardiac function in a mouse model of advanced heart failure?
Does combined physical activity and ACE inhibition improve ACE/ACE-2 balance and cardiac function in a mouse model of advanced heart failure?
Combined physical activity and ACE inhibition additively improve the ACE/ACE-2 balance in a mouse model of advanced heart failure, though without improving cardiac function at the end-stage.
Hypothesis-generating for RAS balance modulation in end-stage HF models; no functional benefit observed, precluding practice change.
Angiotensin-converting enzyme inhibition (ACE-I) and physical activity favorably modulate the ACE/ACE-2 balance. However, it is not clear whether physical activity and ACE-I could synergistically modulate ACE/ACE-2 balance in the course of heart failure (HF). Here, we studied the effects of combined spontaneous physical activity and ACE-I–based treatment on angiotensin (Ang) pattern and cardiac function in a mouse model of HF (Tgαq*44). Tgαq*44 mice with advanced HF (at the age of 12 months) were running spontaneously in a running wheel (exercise training group, ExT) and/or were treated with ACE inhibitor (ACE-I, perindopril, 10 mg/kg) for 2 months. Angiotensin profile was characterized by an LC-MS/MS-based method. The cardiac performance was assessed in vivo by MRI. Ang-(1–7)/Ang II ratio in both plasma and the aorta was significantly higher in the combined treatment group than the ACE-I group or ExT alone, suggesting the additive favorable effects on ACE-2/Ang-(1–7) and ACE/Ang II axes’ balance induced by a combination of ACE-I with ExT. The basal cardiac performance did not differ among the experimental groups of Tgαq*44 mice. We demonstrated additive changes in ACE/ACE-2 balance in both plasma and the aorta by spontaneous physical activity and ACE-I treatment in Tgαq*44 mice. However, these changes did not result in an improvement of failing heart function most likely because the disease was at the end-stage. Ang-(1–7)/Ang II balance represents a valuable biochemical end point for monitoring therapeutic intervention outcome in heart failure.
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Tyrankiewicz et al. (2021) studied Heart Failure (n=51). Spontaneous physical activity (exercise training) combined with perindopril vs. Sedentary non-treated, exercise training alone, or perindopril alone was evaluated on Plasma Ang-(1-7)/Ang II ratio (p=<0.05). Combined treatment with spontaneous physical activity and perindopril significantly increased the plasma Ang-(1-7)/Ang II ratio to 11.19 compared to 0.34 in sedentary controls in mice with advanced heart failure, though it did not improve cardiac function.
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