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Influence of Age, Heart Failure and ACE Inhibitor Treatment on Plasma Renin Activity in Children: Insights from a

Melina Steichert1, Willi Cawello1, Milica Bajcetic2

  • 1Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany.

Frontiers in Bioscience (Landmark Edition)
|January 5, 2024
PubMed

Insights

Plasma renin activity (PRA) is influenced by age, heart failure, and ACE inhibitors in children. Understanding these factors is crucial for using PRA as a prognostic marker in pediatric heart failure.

Area of Science:

  • Pediatric Cardiology
  • Renal Physiology
  • Pharmacology

Background:

  • Plasma renin activity (PRA) is a prognostic marker in adult heart failure.
  • Assessing PRA in pediatric heart failure requires understanding influencing factors like age and treatment.
  • This study evaluates the impact of age, heart failure, and ACE inhibitors on pediatric PRA levels.

Approach:

  • Systematic literature search for PRA levels in healthy children and those with heart failure.
  • Analysis of PRA data from the LENA project in children with heart failure, measuring levels before and during enalapril treatment.
  • Statistical analysis to determine the influence of age, heart failure severity, and ACE inhibitor use on PRA.

Key Points:

  • PRA levels are significantly higher in neonates compared to older children.
  • Children with heart failure exhibit 3-4 times higher PRA than healthy peers.
  • Angiotensin-converting enzyme inhibitor (ACEi) enalapril significantly increased PRA in pediatric heart failure patients.

Conclusions:

  • Age, heart failure status, and ACEi treatment notably influence PRA in children.
  • Accurate assessment of PRA as a clinical parameter in pediatric heart failure necessitates considering these factors.
  • Findings provide critical insights for the clinical application of PRA in pediatric cardiology.
Abstract

Keywords:
angiotensin-converting enzyme inhibitorcongenital heart diseasedilated cardiomyopathyenalaprilheart failurepaediatricplasma renin activity

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