Beta blockers prevent correlation of plasma ACE2 activity with echocardiographic parameters in patients with
Yong Wang1, Maria da Consolação V Moreira, Silvia Heringer-Walther
1*Department of Experimental Cardiology, Excellence Cluster Cardio-Pulmonary System, Justus-Liebig University Giessen, Giessen, Germany; †Department of Internal Medicine, UFMG, Belo Horizonte, Brazil; ‡Instituto Metropolitano de Ensino Superior (IMES)/Univaço, Ipatinga, Brazil; §Department of Cardiology, Charité, Campus Benjamin Franklin, Berlin, Germany; ¶Leibniz-Institute of Molecular Pharmacology, Berlin, Germany; ‖Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany; **Department of Pharmacology and Therapeutics, University College Cork, Cork, Ireland; and ††Department of Pediatric Surgery, Division of Women and Child Health, University of Leipzig, Leipzig, Germany. Wang is now with the Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Insights
Plasma angiotensin-converting enzyme 2 (ACE2) activity is elevated in idiopathic dilated cardiomyopathy (DCM) patients, correlating with disease severity and predicting adverse outcomes. Beta-blocker treatment may diminish this prognostic value.
Area of Science:
- Cardiology
- Biochemistry
- Biomarkers
Background:
- Plasma angiotensin-converting enzyme 2 (ACE2) activity is a prognostic marker in Chagas' disease.
- Idiopathic dilated cardiomyopathy (DCM) is a significant cause of heart failure.
Purpose of the Study:
- To investigate the prognostic potency of circulating ACE2 activity in patients with idiopathic DCM.
- To assess the correlation of ACE2 activity with clinical severity and echocardiographic parameters in DCM.
- To evaluate the impact of beta-blocker treatment on ACE2 activity in DCM.
Main Methods:
- Blood samples were collected from idiopathic DCM patients and healthy controls.
- Patients were classified using the New York Heart Association (NYHA) functional classification.
- Plasma ACE2 activity was measured using a fluorescence method.
Main Results:
- Plasma ACE2 activity was significantly increased in DCM patients and correlated with clinical severity and echocardiographic parameters.
- Elevated plasma ACE2 activity predicted cardiac death and the need for heart transplantation in DCM patients.
- Beta-blocker treatment attenuated the association between ACE2 activity and echocardiographic parameters, diminishing its predictive value.
Conclusions:
- Circulating ACE2 activity is a potential prognostic marker in idiopathic DCM, though less potent than in Chagas' disease.
- Beta-blocker therapy may interfere with the prognostic utility of plasma ACE2 activity in DCM patients.
- Further research is needed to clarify the role of ACE2 in DCM pathogenesis and its therapeutic implications.
Abstract:
Plasma angiotensin-converting enzyme (ACE) 2 activity has been demonstrated to be an independent prognostic marker in Chagas' disease, equally potent as B-type natriuretic peptide. This study aimed to investigate the prognostic potency of circulating ACE2 activity in patients with idiopathic dilated cardiomyopathy (DCM). Blood samples were withdrawn from patients with idiopathic DCM and healthy control subjects. The DCM patients were subdivided into 2 groups according to their New York Heart Association classification. The plasma ACE2 activity was measured by a fluorescence method. Plasma ACE2 activity was significantly increased in DCM patients, correlating with clinical severity. It was correlating with echocardiographic parameters in patients with DCM. Furthermore, plasma ACE2 activity had the potency to predict cardiac death and heart transplantation. However, compared with patients with Chagas' disease, the correlation and predictive value of ACE2 activity in patients with DCM was much less pronounced. Beta blocker treatment in patients with DCM was identified to prevent the association between circulating ACE2 activity and echocardiographic parameters. Although ACE2 activity in blood samples of patients with DCM without beta blockers is potent in correlating with the severity of disease and in predicting death and heart transplantation, its correlation and prediction potency are significantly diminished by beta blocker treatment.
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