Angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker treatment and haemodynamic factors are associated with increased cardiac mRNA expression of angiotensin-converting enzyme 2 in patients with cardiovascular disease

URN zum Zitieren dieses Dokuments:

urn:nbn:de:bvb:355-epub-445057 Copy

DOI zum Zitieren dieses Dokuments:

10.5283/epub.44505 Copy

Lebek, Simon ; Tafelmeier, Maria ; Messmann, Rebecca ; Provaznik, Zdenek ; Schmid, Christof ; Maier, Lars S. ; Birner, Christoph ; Arzt, Michael ; Wagner, Stefan

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Lizenz: Creative Commons Namensnennung-NichtKommerziell 4.0 International PDF - Veröffentlichte Version (2MB)

Veröffentlichungsdatum dieses Volltextes: 26 Jan 2021 16:19

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Diese Publikation ist Teil des DEAL-Vertrags mit Wiley.

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Details

Dokumentenart:	Artikel
Open Access Art:	DEAL (Wiley)
Titel eines Journals oder einer Zeitschrift:	European Journal of Heart Failure
Verlag:	Wiley
Ort der Veröffentlichung:	HOBOKEN
Band:	22
Seitenbereich:	S. 2248-2257
Datum:	5 Oktober 2020
Institutionen:	Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medizin > Lehrstuhl für Innere Medizin II
Projekte:	Die Mechanismen der Arrhythmogenese bei Schlafbezogenen Atmungsstörungen Gefördert von: Deutsche Forschungsgemeinschaft (DFG) (440975675)
Sonstige Projekte:	SFB 1350, DFG WA 2539/4-1, DFG WA 2539/5-1, DFG WA 2539/7-1, DFG WA 2539/8-1, DFG MA 1982/5-1, DFG MA 1982/7-1, Deutsches Zentrum für Herz-Kreislaufforschung
Identifikationsnummer:	Wert Typ 10.1002/ejhf.2020 DOI
Stichwörter / Keywords:	ACE2; EXPRESSION; COVID-19 pandemic; SARS-CoV-2; ACE2; ACE inhibitor; Heart failure; Left ventricular assist device
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Zum Teil
Dokumenten-ID:	44505

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Zusammenfassung

Aims Coronavirus disease 2019 (COVID-19) is a widespread pandemic with an increased morbidity and mortality, especially for patients with cardiovascular diseases. Angiotensin-converting enzyme 2 (ACE2) has been identified as necessary cell entry point for SARS-CoV-2. Previous animal studies have demonstrated an increased ACE2 expression following treatment with either angiotensin-converting ...

Zusammenfassung

Aims Coronavirus disease 2019 (COVID-19) is a widespread pandemic with an increased morbidity and mortality, especially for patients with cardiovascular diseases. Angiotensin-converting enzyme 2 (ACE2) has been identified as necessary cell entry point for SARS-CoV-2. Previous animal studies have demonstrated an increased ACE2 expression following treatment with either angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) that have led to a massive precariousness regarding the optimal cardiovascular therapy during this pandemic. Methods and results We have measured ACE2 mRNA expression using real-time quantitative polymerase chain reaction in atrial biopsies of 81 patients undergoing coronary artery bypass grafting and we compared 62 patients that received ACEi/ARB vs. 19 patients that were not ACEi/ARB-treated. We found atrial ACE2 mRNA expression to be significantly increased in patients treated with an ACEi or an ARB, independent of potential confounding comorbidities. Interestingly, the cardiac ACE2 mRNA expression correlated significantly with the expression in white blood cells of 22 patients encouraging further evaluation if the latter may be used as a surrogate for the former. Similarly, analysis of 18 ventricular biopsies revealed a significant and independent increase in ACE2 mRNA expression in patients with end-stage heart failure that were treated with ACEi/ARB. On the other hand, cardiac unloading with a left ventricular assist device significantly reduced ventricular ACE2 mRNA expression. Conclusion Treatment with ACEi/ARB is independently associated with an increased myocardial ACE2 mRNA expression in patients with coronary artery disease and in patients with end-stage heart failure. Further trials are needed to test whether this association is deleterious for patients with COVID-19, or possibly protective. Nevertheless, haemodynamic factors seem to be equally important for regulation of cardiac ACE2 mRNA expression.

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