Association of plasma angiotensin-(1-7) level and left ventricular function in patients with type 2 diabetes mellitus

• Published in: PloS one Vol. 8; no. 5; p. e62788
• Main Authors: Hao, Pan-Pan, Chen, Yu-Guo, Liu, Yan-Ping, Zhang, Ming-Xiang, Yang, Jian-Min, Gao, Fei, Zhang, Yun, Zhang, Cheng
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.05.2013; Public Library of Science (PLoS)
• Subjects: Aged; Angiotensin; Angiotensin I - blood; Angiotensins; Anthropometry; Biomarkers; Blood; Blood cholesterol; Blood glucose; Brain natriuretic peptide; Cardiomyopathy; Cardiovascular disease; Cholesterol; Coronary vessels; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Diabetic retinopathy; Education; Enzymes; Fasting; Female; Glucose; Glycosylated hemoglobin; Heart; Heart diseases; Heart failure; Hemoglobin; Hospitals; Humans; Hypertension; Inflow; Kinases; Laboratories; Laboratory testing; Low density lipoproteins; Male; Medical records; Medicine; Multiple regression analysis; Natriuretic peptides; Patients; Peptide Fragments - blood; Plasma; Prevention; Public health; Rats; Regression analysis; Rodents; Stroke Volume; Type 2 diabetes; Ultrasound; Velocity; Ventricle; Ventricular Dysfunction, Left - blood; Ventricular Dysfunction, Left - complications; Ventricular Dysfunction, Left - physiopathology; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0062788

We recently found that overexpression of angiotensin (Ang)-converting enzyme 2, which metabolizes Ang-II to Ang-(1-7) and Ang-I to Ang-(1-9), may prevent diabetes-induced left ventricular remodeling and dysfunction in rats. Our objective was to evaluate the association of plasma Ang-(1-7) level and left ventricular function in patients with type 2 diabetes mellitus. We measured the left ventricular ejection fraction (EF), ratio of early to late left ventricular filling velocity (E/A) and ratio of early diastolic mitral inflow to annular velocity (E/Ea) by ultrasonography in 110 patients with type 2 diabetes mellitus for more than 5 years. Anthropometric and fasting blood values were obtained from medical records. The plasma Ang-(1-7) level in patients with a poor EF (<50%) was significantly lower than that in patients with EF ≥50%; the level in patients with E/A <1 was significantly lower than that in patients with E/A ≥1; and the level in patients with E/Ea >15 was significantly lower than that in patients with E/Ea ≤15. Ang-(1-7) level was negatively correlated with E/Ea and Log-N-terminal pro-B-type natriuretic peptide and positively with EF and E/A. Stepwise multiple regression analysis revealed that Ang-(1-7), hemoglobin A1c and Ang-II levels as well as duration of diabetes predicted EF; Ang-(1-7) level, fasting blood glucose, low-density lipoprotein cholesterol level and duration of diabetes predicted E/A; and Ang-(1-7) and hemoglobin A1c levels predicted E/Ea. Plasma Ang-(1-7) level is independently associated with left ventricular function in patients with type 2 diabetes mellitus and may be a biomarker for assessing cardiac function in such patients.