The Serum Angiotensin-converting Enzyme 2 and Angiotensin-(1-7) Concentrations after Optimal Therapy for Acute Decompensated Heart Failure with Reduced Ejection Fraction.

OBJECTIVE Elucidation of the role of angiotensin-converting enzyme (ACE)2/angiotensin (Ang)-(1-7)/Mas receptor axis in heart failure is necessary. No previous study has reported serial changes in ACE2 and Ang-(1-7) concentrations after optimal therapy (OP) in acute heart failure (AHF) patients. We aimed to investigate serial changes in serum ACE2 and Ang-(1-7) concentrations after OP in AHF patients with reduced ejection fraction (EF). METHODS ACE2 and Ang-(1-7) concentrations were measured in 68 AHF patients with reduced EF immediately after admission and 1 and 3 months after OP. These parameters were compared with the healthy individuals at three time points. RESULTS In the acute phase, Ang-(1-7) and ACE2 concentrations was statistically significantly lower and higher in AHF patients than the healthy individuals (2.40±1.11 vs. 3.1±1.1 ng/mL, P<0.005 and 7.45±3.13 vs. 4.84±2.25 ng/mL, P<0.005, respectively). At 1 month after OP, Ang-(1-7) concentration remained lower in AHF patients than the healthy individuals (2.37±1.63 vs. 3.1±1.1 ng/mL, P<0.05); however, there was no statistically significant difference in ACE2 concentration between AHF patients and the healthy individuals. At 3 months after OP, there were no statistically significant differences in Ang-(1-7) and ACE2 concentrations between AHF patients and the healthy individuals. CONCLUSION ACE2 concentration was equivalent between AHF patients and the healthy individuals at months 1 and 3 after OP, and Ang-(1-7) concentration was equivalent at months 3 after OP.