title: Balance between angiotensin converting enzyme and angiotensin converting enzyme 2 in patients with chronic heart failure.
abstract: OBJECTIVE
  It has been reported that angiotensin converting enzyme 2 (ACE2) is an endogenous counter-regulator of the renin-angiotensin-aldosterone system. However, angiotensin converting enzyme (ACE)/ACE2 balance in the development of human heart failure is not well established.
  
  
  METHODS
  Here we evaluated the expression of ACE and ACE2 at the mRNA and protein levels in the myocardium of 78 patients with mild or moderate to severe heart failure and in 13 cases with normal myocardium.
  
  
  RESULTS
  In the myocardium of patients with dilated or ischemic cardiomyopathy, ACE and ACE2 expression at the mRNA and protein levels was significantly increased compared with those in normal myocardium (P<0.01, P<0.01, respectively). The ratios of ACE/ACE2 mRNA and ACE/ACE2 were lower in the myocardium of patients with mild heart failure than those in normal myocardium but higher than those in patients with moderate to severe heart failure.
  
  
  CONCLUSIONS
  ACE and ACE2 expression at the mRNA and protein levels are significantly increased in the myocardium of patients with heart failure. The compensatory mechanism of patients with mild heart may cause the decreased ACE/ACE2 ratio. However, increased ACE/ACE2 ratios may induce angiotensin II over-activation and accelerate cardiac remodeling in patients with moderate to severe heart failure.
authors: Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, China.
authors: Jiang
authors: J
authors: Wang
authors: Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, China.
authors: Nan
authors: N
authors: Li
authors: Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, China.
authors: Feng
authors: F
authors: Gao
authors: Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, China.
authors: Rong
authors: R
authors: Song
authors: Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, China.
authors: Shanjun
authors: S
authors: Zhu
authors: Department of Cardiology, Xinqiao Hospital, the Third Military Medical University, China 1050179540@qq.com.
authors: Zhaohua
authors: Z
authors: Geng
mesh_terms: D000328:Adult; D000368:Aged; D000085962:Angiotensin-Converting Enzyme 2; D015153:Blotting, Western; D002908:Chronic Disease; D005260:Female; D015971:Gene Expression Regulation, Enzymologic; D006333:Heart Failure / Q000201:enzymology* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics / Q000378:metabolism*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism
chemical_list: D012333:RNA, Messenger; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A; C000705307:ACE2 protein, human; D000085962:Angiotensin-Converting Enzyme 2
keywords: Chronic heart failure; angiotensin II; angiotensin converting enzyme; angiotensin converting enzyme 2; renin–angiotensin–aldosterone system