Determinants of soluble angiotensin-converting enzyme 2 concentrations in adult patients with complex congenital heart disease.

Autor: Raedle-Hurst T; Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany. tanja.raedle-hurst@uks.eu., Wissing S; Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany., Mackenstein N; Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany., Obeid R; Department of Clinical Chemistry and Laboratory Medicine, Saarland University Medical Center, Homburg/Saar, Germany., Geisel J; Department of Clinical Chemistry and Laboratory Medicine, Saarland University Medical Center, Homburg/Saar, Germany., Wagenpfeil S; Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar, Germany., Abdul-Khaliq H; Department of Pediatric Cardiology, Saarland University Medical Center, Homburg/Saar, Germany.
Jazyk: angličtina
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2022 Feb; Vol. 111 (2), pp. 154-162. Date of Electronic Publication: 2020 Dec 05.
DOI: 10.1007/s00392-020-01782-y
Abstrakt: Background: Angiotensin-converting enzyme (ACE) 2 is known to be a functional receptor for SARS-CoV-2 in the current pandemic. Soluble ACE2 (sACE2) concentrations are elevated in patients with various cardiovascular disorders including heart failure.
Methods: In a total of 182 consecutive adult patients with complex congenital heart disease (CHD) and 63 healthy controls, sACE2 concentrations were measured in serum using the Human ACE2 ® assay by Cloud-Clone Corporation and associated with clinical, laboratory and echocardiographic parameters.
Results: Median sACE2 levels were increased in patients with complex CHD as compared to healthy controls (761.9 pg/ml vs 365.2 pg/ml, p < 0.001). Moreover, sACE2 concentrations were significantly elevated in patients with a higher NYHA class ≥ III (1856.2 pg/ml vs 714.5 pg/ml in patients with NYHA class I/II, p < 0.001). Using linear regression analysis, higher sACE2 levels were associated with a higher NYHA class ≥ III, more severe CHD, a morphological left systemic ventricle, higher creatinine and the use of mineralocorticoid receptor antagonists (MRA) in the univariable model. The use of ACE inhibitors or angiotensin receptor blockers (ARB) was associated with lower sACE2 levels. In the multivariable model, higher sACE2 levels were independently associated with a higher NYHA class ≥ III (p = 0.002) and lower sACE2 levels with the use of ACE inhibitors or ARB (p = 0.001).
Conclusion: Soluble ACE2 concentrations were significantly increased in all types of complex CHD with highest levels found in patients with NYHA class ≥ III. Moreover, a higher NYHA class ≥ III was the most significant determinant that was independently associated with elevated sACE2 concentrations.
(© 2020. The Author(s).)
Databáze: MEDLINE