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The angiotensin(Ang) converting enzyme 2 (ACE2)-Ang-(1-7)-Mas receptor axis might be a promising therapeutic target for pulmonary arterial hypertension. We previously showed that serum ACE2 and Ang-(1-7) levels was decreased in the patients with pulmonary arterial hypertension(PAH) due to congenital heart disease(CHD). They were negatively correlated with mean pulmonary arterial pressure(mPAP). In this study, To observe the changes of plasma ACE2 and Ang-(1-7) in patients with CHD-PAH before and after intervention closure.
59 patients with CHD and 20 normal control patients (group A) were involved in the research. The patients with CHD were divided into 21 cases of nonpulmonary hypertension (group B), 20 cases of mild pulmonary hypertension (group C) and 18 cases of moderate pulmonary hypertension (group D). The serum levels of ACE2 and Ang-(1-7) were detected by enzyme-linked immunosorbent assay(ELISA) at 1 day before operation and 2 days after operation.
Before operation, in group D, their serum ACE2 level was significantly lower than that in the group A, group B and group C (13.11±1.93 vs 16.99±1.77, 21.06±1.01, 16.65±1.94 U/l, P < 0.05); their serum Ang-(1-7) level was significantly lower than that in the group A, group B and group C (17.54±2.10 vs 19.31±1.34, 23.16±2.74, 20.07±2.11 pg/ml, P < 0.05). After operation, compared to 1 day before operation, In group C, their serum ACE2 level was slightly increased (16.65±1.94 vs 17.01±1.96 U/l, P = 0.20), but not statistically significant; their serum Ang-(1-7) level was increased (20.07±2.11 vs 20.45±2.20 pg/ml, P < 0.05); in group D, their serum ACE2 level was increased (13.11±1.93 vs 13.52±2.19 U/l, P < 0.05); their serum Ang-(1-7) level was increased (17.54±2.10 vs 18.92±2.44 pg/ml, P < 0.001).
Serum ACE2 and Ang-(1-7) levels were increased after interventional closure in patients with CHD-PAH. Detection of plasma ACE2 and Ang-(1-7) level may be beneficial to evaluate the postoperative prognosis in patients with CHD-PAH.