Key result
Elevated ELA/Ang II ratio accurately diagnoses acute heart failure with an AUC of ~0.88.
Why the study?
The clinical significance of serum ratios of Ang (1-7)/Ang II and Elabela/Ang II in patients with acute heart failure and type I cardiorenal syndrome was not well established.
Do serum Ang (1-7)/Ang II and ELA/Ang II ratios have diagnostic value for acute heart failure and type I cardiorenal syndrome?
Cross-Sectional (n=100)
Single-blind
No
Do serum Ang (1-7)/Ang II and ELA/Ang II ratios have diagnostic value for acute heart failure and type I cardiorenal syndrome?
Effect estimate: AUC 0.8783 (95% CI 0.7953-0.9612)
p-value: p=<0.0001
The serum ELA/Ang II ratio demonstrates strong diagnostic potential for acute heart failure and may serve as an adjunctive indicator for type I cardiorenal syndrome.
ELA/Ang II ratio merits evaluation as a diagnostic aid in acute heart failure; case-control evidence leaves open its role in clinical practice.
Introduction: This study assesses the serum levels of Elabela (ELA/Apela) and apelin receptor (APJ), angiotensin II (Ang II) and angiotensin-converting enzyme (ACE), as well as Ang (1-7) and ACE2, in patients with acute heart failure (AHF) and type I cardiorenal syndrome (CRS). Methods: A total of 31 AHF patients, 38 type I CRS patients and 31 healthy controls were enrolled. Serum concentrations of ELA, APJ, Ang II, ACE, Ang (1-7) and ACE2 were measured using ELISA. ROC curves were used to assess the diagnostic performance of the ratios of Ang (1-7)/Ang II and ELA/Ang II for AHF and type I CRS. Results: The mean ratios of Ang (1-7)/Ang II and ELA/Ang II increased in both AHF and CRS groups compared to the control group. However, the ratio of ELA/Ang II significantly decreased in the CRS group compared to the AHF group. The ratio of ELA/Ang II negatively correlated with creatinine and positively correlated with eGFR in CRS patients. The AUC for Ang (1-7)/Ang II in diagnosing AHF and type I CRS was 0.7128 and 0.6978, respectively. The AUC for ELA/Ang II in diagnosing AHF and type I CRS was 0.8783 and 0.7530, respectively. Conclusion: The ELA/Ang II ratio can be used as an additional indicator for diagnosing AHF or type I CRS. Although the ELA/Ang II ratio is particularly well correlated with eGFR in patients with type I CRS, the value of the ratio in evaluating the degree of renal impairment in these patients remains to be further studied.
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Zheng et al. (2026) conducted a cross-sectional in Acute Heart Failure and Type I Cardiorenal Syndrome (n=100). Ang (1-7)/Ang II and ELA/Ang II ratios vs. Healthy controls was evaluated on Diagnostic performance (AUC) of ELA/Ang II ratio for acute heart failure (AUC 0.8783, 95% CI 0.7953-0.9612, p=<0.0001). The Elabela (ELA)/Ang II ratio was significantly elevated in patients with acute heart failure and type I cardiorenal syndrome, demonstrating high diagnostic accuracy for acute heart failure with an AUC of 0.8783.
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