title: Association of plasma angiotensin-(1-7) level and left ventricular function in patients with type 2 diabetes mellitus.
abstract: BACKGROUND
  We recently found that overexpression of angiotensin (Ang)-converting enzyme 2, which metabolizes Ang-II to Ang-(1-7) and Ang-I to Ang-(1-9), may prevent diabetes-induced left ventricular remodeling and dysfunction in rats. Our objective was to evaluate the association of plasma Ang-(1-7) level and left ventricular function in patients with type 2 diabetes mellitus.
  
  
  RESULTS
  We measured the left ventricular ejection fraction (EF), ratio of early to late left ventricular filling velocity (E/A) and ratio of early diastolic mitral inflow to annular velocity (E/Ea) by ultrasonography in 110 patients with type 2 diabetes mellitus for more than 5 years. Anthropometric and fasting blood values were obtained from medical records. The plasma Ang-(1-7) level in patients with a poor EF (<50%) was significantly lower than that in patients with EF ≥50%; the level in patients with E/A <1 was significantly lower than that in patients with E/A ≥1; and the level in patients with E/Ea >15 was significantly lower than that in patients with E/Ea ≤15. Ang-(1-7) level was negatively correlated with E/Ea and Log-N-terminal pro-B-type natriuretic peptide and positively with EF and E/A. Stepwise multiple regression analysis revealed that Ang-(1-7), hemoglobin A1c and Ang-II levels as well as duration of diabetes predicted EF; Ang-(1-7) level, fasting blood glucose, low-density lipoprotein cholesterol level and duration of diabetes predicted E/A; and Ang-(1-7) and hemoglobin A1c levels predicted E/Ea.
  
  
  CONCLUSIONS
  Plasma Ang-(1-7) level is independently associated with left ventricular function in patients with type 2 diabetes mellitus and may be a biomarker for assessing cardiac function in such patients.
authors.affiliation: Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan, Shandong, China.
authors.forename: Pan-Pan
authors.initials: PP
authors.lastname: Hao
authors.forename: Yu-Guo
authors.initials: YG
authors.lastname: Chen
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Liu
authors.forename: Ming-Xiang
authors.initials: MX
authors.lastname: Zhang
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yang
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000368:Aged; D000803:Angiotensin I / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000097:blood*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000150:complications* / Q000503:physiopathology
chemical_list: D010446:Peptide Fragments; D000803:Angiotensin I; C118790:angiotensin I (1-7)