Association Between the Angiotensin II/Angiotensin (1-7) Imbalance and Left Ventricular Hypertrophy in Patients with Heart Failure

Q4 Medicine

Acta Medica Bulgarica Pub Date : 2021-10-01 DOI:10.2478/amb-2021-0029

A. Nikolov, M. Tzekova, K. Kostov, A. Kostadinovska, S. Blazheva

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引用次数: 0

Abstract

Abstract Introduction: Angiotensin II (AngII) and angiotensin-(1-7) [Ang-(1-7)] are key components of the renin angiotensin system (RAS). They exhibit counter-regulatory effects in the systemic circulation, as well as in tissues important for cardiovascular regulation. Aim: To investigate the association between the AngII/Ang-(1-7) balance and left ventricular hypertrophy (LVH) in patients with heart failure and mid-range ejection fraction (HFmrEF). Material and methods: 56 patients with HFmrEF were included, with a mean age of 65.62 ± 9.69 years and 22 age- and sex-matched healthy subjects, their mean age - 56.4 ± 5.53 years. The patients were divided in two subgroups: subjects with left ventricular hypertrophy (n = 32); (HFmrEF+LVH) and subjects without left ventricular hypertrophy (n = 24); (HFmrEFLVH). AngII and Ang-(1-7) levels were measured with an ELISA kit. Results: Patients with HFmrEF+LVH showed significantly higher levels of AngII: 8.53 pg/mL (1.47 ÷ 13.0) than HFmrEF-LVH – 1.33 pg/mL (0.47 ÷ 6.93) and healthy controls – 1.53 pg/mL (0.27 ÷ 5.21); (KW = 3.48; p = 0.04). There was no significant difference between Ang-(1-7) levels in all patients compared to controls (p > 0.05). AngII/Ang-(1-7) ratio was significantly higher in all patients than controls: 3.81 (2.03 ÷ 6.66) vs. 1.5 (0.93 ÷ 2.06) (KW = 18.68; p < 0.001). Patients with HFmrEF+LVH showed statistically higher AngII/Ang-(1-7) ratio compared with controls (4.7 vs. 1.5). Moreover, subjects with LVH showed the highest AngII/Ang-(1-7) ratio among all particpants in the study. The AngII/Ang-(1-7) ratio correlated with LVH (r = -0.39; p = 0.03), DBP (r = 0.25; p = 0.04), HDL (r = 0.33; p = 0.01), SBP (r = 0.34; p = 0.01). Conclusion: Our study showed an association between AngII/Ang-(1-7) ratio, blood pressure and LVH. The imbalance between Ang-II and Ang-(1-7) could contribute to the mechanisms determining LVH in HFmrEF. Further studies are warranted to clarify whether evaluation of serum Ang-II/Ang-(1-7) ratio could predict LVH development in patients with HFmrEF.

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心力衰竭患者血管紧张素Ⅱ/血管紧张素（1-7）失衡与左心室肥厚的关系

摘要简介:血管紧张素II (AngII)和血管紧张素-(1-7)[Ang-(1-7)]是肾素血管紧张素系统(RAS)的关键组成部分。它们在体循环以及对心血管调节重要的组织中表现出反调节作用。目的:探讨心衰患者AngII/Ang-(1-7)平衡与左室肥厚(LVH)及中程射血分数(HFmrEF)的关系。材料与方法:纳入56例HFmrEF患者，平均年龄为65.62±9.69岁;22例年龄与性别匹配的健康受试者，平均年龄为- 56.4±5.53岁。患者被分为两个亚组:左心室肥厚患者(n = 32);(HFmrEF+LVH)和无左室肥厚的受试者(n = 24);(HFmrEFLVH)。采用ELISA试剂盒检测AngII和Ang-(1-7)水平。结果:HFmrEF+LVH组患者AngII水平为8.53 pg/mL (1.47 ÷ 13.0)，显著高于HFmrEF-LVH组的1.33 pg/mL (0.47 ÷ 6.93)和健康对照组的1.53 pg/mL (0.27 ÷ 5.21);(kw = 3.48;P = 0.04)。与对照组相比，所有患者的Ang-(1-7)水平无显著差异(p < 0.05)。所有患者的AngII/Ang-(1-7)比值均显著高于对照组:3.81 (2.03 ÷ 6.66)比1.5 (0.93 ÷ 2.06) (KW = 18.68;P < 0.001)。HFmrEF+LVH组患者AngII/Ang-(1-7)比值高于对照组(4.7 vs. 1.5)。此外，LVH受试者的AngII/Ang-(1-7)比值在所有受试者中最高。AngII/Ang-(1-7)比值与LVH相关(r = -0.39;p = 0.03)， DBP (r = 0.25;p = 0.04)， HDL (r = 0.33;p = 0.01)，收缩压(r = 0.34;P = 0.01)。结论:我们的研究显示AngII/Ang-(1-7)比值、血压和LVH之间存在相关性。Ang- ii和Ang-(1-7)之间的失衡可能参与了HFmrEF中LVH的决定机制。需要进一步的研究来阐明血清Ang- ii /Ang-(1-7)比值是否可以预测HFmrEF患者LVH的发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Medica Bulgarica Medicine-Medicine (all)

CiteScore

0.30

自引率

0.00%

发文量

审稿时长

25 weeks

期刊介绍： About 30 years ago - in 1973, on the initiative of the Publishing House „Medicine and Physical Culture", namely its former director Mr. Traian Ivanov, the Ministry of Health set up and accepted to subsidize a new medical magazine that was to be published only in the English language and had to reflect the status and the achievements of the Bulgarian medical science. Thus the language barrier was overcome and stable relations were established with the international medical society, large libraries, and university centers. The famous internationally known scientist professor Assen A. Hadjiolov was elected edition-in-chief by the first editorial staff and the magazine was named Acta Medica Bulgarica.