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 Ang-(1-7) levels was decreased in the patients with pulmonary arterial hypertension(PAH) due to congenital heart disease(CHD). In this study, To observe the changes of plasma Angiotensin-(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 to severe pulmonary hypertension (group D). The serum levels of 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 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, echocardiographic assessment showed that pulmonary artery systolic pressure was decreased in group C and group D(all P < 0.05). In group C, 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 Ang-(1-7) level was increased (17.54±2.10 vs 18.92±2.44 pg/ml, P < 0.001).
Serum Ang-(1-7) levels declined in patients with CHD-PAH. The decline of pulmonary artery pressure was decreased accompanied by an increase in Ang-(1-7) after interventional closure. Detection of plasma Ang-(1-7) level may be benifical to evaluate the postoperative prognosis in patients with CHD-PAH.
Key words: congenital heart disease; pulmonary arterial hypertension; Ang-(1-7)