Maria Jose Soler1, Montserrat Batlle2, Marta Riera3, Begoña Campos4, José Tomás Ortiz-Perez5, Lidia Anguiano3, Heleia Roca-Ho3, Marta Farrero5, Lluis Mont5, Julio Pascual3, Felix Perez-Villa5. 1. Nephrology Department, Hospital del Mar. IMIM (Hospital del Mar Medical Research Institute). Barcelona, Spain; Nephrology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain. Electronic address: mjsoler01@gmail.com. 2. Cardiovascular Institute, Hospital Clínic de Barcelona and Institut de Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Electronic address: mbatlle@clinic.cat. 3. Nephrology Department, Hospital del Mar. IMIM (Hospital del Mar Medical Research Institute). Barcelona, Spain. 4. Department of Clinical Foundations, University of Barcelona, Spain. 5. Cardiovascular Institute, Hospital Clínic de Barcelona and Institut de Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Abstract
OBJECTIVES: The authors sought to evaluate cardiac activity of angiotensin-converting enzyme (ACE) and ACE2 after heart transplantation (HT) and its relation with acute rejection (AR) and chronic allograft vasculopathy (CAV). BACKGROUND: The renin-angiotensin system is altered in heart failure and HT. However, ACE and ACE2 activities in post-HT acute and chronic rejection have not been previously studied. METHODS: HT patients (n = 45) were included when appropriate serial endomyocardial biopsies (EMB) and coronary angiography were available for analysis. In 21 patients, three post-HT time points were selected for CAV study in EMB tissue: basal (0-3 wks), second (2-3 months) and third (4-5 months). At 10 years post-HT, CAV was evaluated by coronary angiography (CA) and patients were grouped by degree of CAV: 0-1, non-CAV (n = 15) and 2-3, CAV (n = 6). For the AR study, 28 HT patients with evidence of one EMB rejection at grade 3 and two EMB grade 1A and/or 1B rejections were selected. RESULTS: Post-HT, ACE2 activity was increased in the CAV group, compared to non-CAV. Patients with AR showed increased ACE, but not ACE2, activity. CONCLUSIONS: Our results suggest that early post-HT cardiac ACE2 activity may have an important role in CAV development. In contrast, ACE activity was increased in AR. The renin-angiotensin system seems to be altered after HT and strategies to balance the system may be useful.
OBJECTIVES: The authors sought to evaluate cardiac activity of angiotensin-converting enzyme (ACE) and ACE2 after heart transplantation (HT) and its relation with acute rejection (AR) and chronic allograft vasculopathy (CAV). BACKGROUND: The renin-angiotensin system is altered in heart failure and HT. However, ACE and ACE2 activities in post-HT acute and chronic rejection have not been previously studied. METHODS: HT patients (n = 45) were included when appropriate serial endomyocardial biopsies (EMB) and coronary angiography were available for analysis. In 21 patients, three post-HT time points were selected for CAV study in EMB tissue: basal (0-3 wks), second (2-3 months) and third (4-5 months). At 10 years post-HT, CAV was evaluated by coronary angiography (CA) and patients were grouped by degree of CAV: 0-1, non-CAV (n = 15) and 2-3, CAV (n = 6). For the AR study, 28 HT patients with evidence of one EMB rejection at grade 3 and two EMB grade 1A and/or 1B rejections were selected. RESULTS: Post-HT, ACE2 activity was increased in the CAV group, compared to non-CAV. Patients with AR showed increased ACE, but not ACE2, activity. CONCLUSIONS: Our results suggest that early post-HT cardiac ACE2 activity may have an important role in CAV development. In contrast, ACE activity was increased in AR. The renin-angiotensin system seems to be altered after HT and strategies to balance the system may be useful.
Authors: Zaira Palomino Jara; Marcelo Yudi Icimoto; Rodrigo Yokota; Amanda Aparecida Ribeiro; Fernando Dos Santos; Leandro Ezequiel de Souza; Ingrid Kazue Mizuno Watanabe; Maria do Carmo Franco; Jorge Luiz Pesquero; Maria Claudia Irigoyen; Dulce Elena Casarini Journal: Front Med (Lausanne) Date: 2019-01-23