Centre for Biomedical Research, Hull York Medical School, University of Hull, Hull, UK.
J Card Fail. 2010 Feb;16(2):157-63. doi: 10.1016/j.cardfail.2009.09.005. Epub 2009 Nov 4.
Angiotensin-converting enzyme (ACE) 2 is a novel homologue of ACE. It metabolizes angiotensin (Ang)II to Ang-(1-7). This study aims to investigate the diagnostic and prognostic potency of circulating ACE2 activity in patients with heart failure (HF) from Chagas' disease (CD).
Blood samples were obtained from 111 CD patients and 40 age- and gender-matched healthy subjects. The CD patients were further subdivided according to their New York Heart Association classification. ACE2 activity was significantly increased in CD patients with HF, but not in patients without systolic dysfunction. Moreover, plasma ACE2 activity was significantly correlated with their clinical severity and echocardiographic parameters. Importantly, the potency of circulating ACE2 activity in CD patients was equally potent as that of B-type natriuretic peptide to predict cardiac death and heart transplant. Most importantly, patients with both parameters elevated were on a 5-fold higher risk to reach an endpoint than patients with increase in only 1 of the 2 parameters.
Determination of ACE2 activity may provide a new and important diagnostic and prognostic marker for patients with CD. ACE2 activity and BNP concentration have additive predictive value and may be used in combination to offer a new dimension of prediction in HF.
血管紧张素转换酶 2（ACE2）是 ACE 的新型同源物。它将血管紧张素（Ang）II 代谢为 Ang-(1-7)。本研究旨在探讨 Chagas 病（CD）心力衰竭（HF）患者循环 ACE2 活性的诊断和预后价值。
采集了 111 例 CD 患者和 40 名年龄和性别匹配的健康受试者的血样。根据纽约心脏协会分类，将 CD 患者进一步分为亚组。HF 患者的 CD 患者 ACE2 活性显著升高，但无收缩功能障碍的患者则没有。此外，血浆 ACE2 活性与临床严重程度和超声心动图参数显著相关。重要的是，CD 患者循环 ACE2 活性的预测能力与 B 型利钠肽相当，可预测心脏死亡和心脏移植。最重要的是，与仅 1 项参数升高的患者相比，2 项参数均升高的患者达到终点的风险高 5 倍。
ACE2 活性的测定可能为 CD 患者提供一个新的重要的诊断和预后标志物。ACE2 活性和 BNP 浓度具有相加的预测价值，可联合使用以提供 HF 预测的新维度。
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