Key result
Cardiac ACE2 mRNA in atrial appendage tissue was positively associated with age, COPD, previous stroke, and chronic use of antithrombotic agents and thiazide diuretics.
Why the study?
To explore how cardiac ACE2 changes with age, cardiac diseases, comorbid conditions, and pharmaceutical regimens to understand potential hormonal unbalance facilitating SARS-CoV-2 vulnerabilities in older adults.
Answers are grounded in this paper and cite their sources.
Cardiac ACE2 expression increases with age, specific comorbidities, and certain medications, potentially influencing SARS-CoV-2 vulnerability in older adults.
PURPOSE OF REVIEW: Hospitalizations for COVID-19 dramatically increase with age. This is likely because of increases in fragility across biological repair systems and a weakened immune system, including loss of the cardiorenal protective arm of the renin--angiotensin system (RAS), composed of angiotensin-converting enzyme-2 (ACE2)/angiotensin-(1--7) [Ang-(1--7)] and its actions through the Mas receptor. The purpose of this review is to explore how cardiac ACE2 changes with age, cardiac diseases, comorbid conditions and pharmaceutical regimens in order to shed light on a potential hormonal unbalance facilitating SARs-CoV-2 vulnerabilities in older adults. RECENT FINDINGS: Increased ACE2 gene expression has been reported in human hearts with myocardial infarction, cardiac remodeling and heart failure. We also found ACE2 mRNA in atrial appendage tissue from cardiac surgical patients to be positively associated with age, elevated by certain comorbid conditions (e.g. COPD and previous stroke) and increased in conjunction with patients' chronic use of antithrombotic agents and thiazide diuretics but not drugs that block the renin--angiotensin system. SUMMARY: Cardiac ACE2 may have bifunctional roles in COVID-19 as ACE2 not only mediates cellular susceptibility to SARS-CoV-2 infection but also protects the heart via the ACE2/Ang-(1--7) pathway. Linking tissue ACE2 from cardiac surgery patients to their comorbid conditions and medical regimens provides a unique latform to address the influence that altered expression of the ACE2/Ang-(1-7)/Mas receptor axis might have on SARs-CoV-2 vulnerability in older adults.
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Wang et al. (2021) conducted a review in COVID-19 and cardiac diseases. Aging and comorbid conditions was evaluated on ACE2 gene expression. Cardiac ACE2 mRNA in atrial appendage tissue was positively associated with age, COPD, previous stroke, and chronic use of antithrombotic agents and thiazide diuretics.
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