title: Beta blockers prevent correlation of plasma ACE2 activity with echocardiographic parameters in patients with idiopathic dilated cardiomyopathy.
abstract: Plasma angiotensin-converting enzyme (ACE) 2 activity has been demonstrated to be an independent prognostic marker in Chagas' disease, equally potent as B-type natriuretic peptide. This study aimed to investigate the prognostic potency of circulating ACE2 activity in patients with idiopathic dilated cardiomyopathy (DCM). Blood samples were withdrawn from patients with idiopathic DCM and healthy control subjects. The DCM patients were subdivided into 2 groups according to their New York Heart Association classification. The plasma ACE2 activity was measured by a fluorescence method. Plasma ACE2 activity was significantly increased in DCM patients, correlating with clinical severity. It was correlating with echocardiographic parameters in patients with DCM. Furthermore, plasma ACE2 activity had the potency to predict cardiac death and heart transplantation. However, compared with patients with Chagas' disease, the correlation and predictive value of ACE2 activity in patients with DCM was much less pronounced. Beta blocker treatment in patients with DCM was identified to prevent the association between circulating ACE2 activity and echocardiographic parameters. Although ACE2 activity in blood samples of patients with DCM without beta blockers is potent in correlating with the severity of disease and in predicting death and heart transplantation, its correlation and prediction potency are significantly diminished by beta blocker treatment.
authors.affiliation: *Department of Experimental Cardiology, Excellence Cluster Cardio-Pulmonary System, Justus-Liebig University Giessen, Giessen, Germany; †Department of Internal Medicine, UFMG, Belo Horizonte, Brazil; ‡Instituto Metropolitano de Ensino Superior (IMES)/Univaço, Ipatinga, Brazil; §Department of Cardiology, Charité, Campus Benjamin Franklin, Berlin, Germany; ¶Leibniz-Institute of Molecular Pharmacology, Berlin, Germany; ‖Department of Physics, Humboldt-Universität zu Berlin, Berlin, Germany; **Department of Pharmacology and Therapeutics, University College Cork, Cork, Ireland; and ††Department of Pediatric Surgery, Division of Women and Child Health, University of Leipzig, Leipzig, Germany. Wang is now with the Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.forename: Maria da Consolação V
authors.initials: Mda C
authors.lastname: Moreira
authors.forename: Silvia
authors.initials: S
authors.lastname: Heringer-Walther
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schultheiss
authors.forename: Wolf-Eberhard
authors.initials: WE
authors.lastname: Siems
authors.forename: Niels
authors.initials: N
authors.lastname: Wessel
authors.forename: Thomas
authors.initials: T
authors.lastname: Walther
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D000085962:Angiotensin-Converting Enzyme 2; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000503:physiopathology; D016022:Case-Control Studies; D003643:Death; D004452:Echocardiography; D005260:Female; D016027:Heart Transplantation / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D000319:Adrenergic beta-Antagonists; D007703:Peptidyl-Dipeptidase A; C000705307:ACE2 protein, human; D000085962:Angiotensin-Converting Enzyme 2