The Study Of The Changes Of Serum Angiotensin-Converting Enzyme2in Patients Of Congenital Heart Disease With Pulmonary Hypertension

Objective:We observed the Angiotensin-Converting Enzyme2(ACE2) protein contents and activity in the serum with Congenital Heart Disease(CHD) combined with pulmonary hypertension(PH),and investigated the correlation of those with pulmonary hypertension.Methods:104patients with Congenital Heart Disease and33normal control patients were collected,The patients with congenital heart disease were divided into55cases of non-pulmonary arterial hypertension group,25cases of mild to moderate pulmonary arterial hypertension,and24cases of severe pulmonary arterial hypertension.The serum level of ACE2protein contents were detected by enzyme-linked immunosorbent assay(ELISA),ACE2activity were detected by activity colorimetric. Statistical analysis was performed by using SPSS17.0software.Results:1.The ACE2protein contents in plasma measured by enzyme-linked immunosorbent assay were(15.79±5.03)u/l,(21.49±4.19)u/l,(15.84±3.80)u/l,(12.96±5.98)u/l in normal control group(group A),Congenital Heart Disease with non-pulmonary arterial hypertension group(group B),Congenital Heart Disease with mild to moderate pulmonary arterial hypertension group(group C),Congenital Heart Disease with severe pulmonary arterial hypertension group(group D) before surgery.The levels of ACE2protein contents showed significantly difference between group A and B(P<0.001);The levels of ACE2protein contents showed no significant difference between group A and C(P>0.05);The levels of ACE2protein contents showed significantly difference between group A and D(P<0.05);The levels of ACE2protein contents showed significantly difference between group B and C(P<0.001);The levels of ACE2protein contents showed significantly difference between group B and D(P<0.001);The levels of ACE2protein contents showed significantly difference between group C and D(P<0.05).2.Through correlation and regression analysis,there was a negative correlation between Pulmonary arterial pressure and ACE2protein contents(r=-0.564,p<0.001).3.The ACE2activity in plasma measured by activity colorimetric were(1.75±0.82)u/l,(1.92±0.64)u/l,(1.53±0.40)u/l,(1.28±0.40)u/l in normal control group(group A),Congenital Heart Disease with non-pulmonary arterial hypertension group(group B),Congenital Heart Disease with mild to moderate pulmonary arterial hypertension group(group C),Congenital Heart Disease with severe pulmonary arterial hypertension group(group D) before surgery. The levels of ACE2activity showed no significant difference between group A and B (P>0.05);The levels of ACE2activity showed no significant difference between group A and C(P>0.05);The levels of ACE2activity showed no significant difference between group A and D(P>0.05);The levels of ACE2activity showed no significant difference between group B and C(P>0.05);The levels of ACE2activity showed significantly difference between group B and D(P<0.05);The levels of ACE2activity showed no significant difference between group C and D(P>0.05).4.Through correlation and regression analysis,there was a negative correlation between Pulmonary arterial pressure and ACE2activity(r=-0.367,p<0.01).5.The ACE2protein contents in plasma measured by enzyme-linked immunosorbent assay were(15.79±5.03)u/l,(18.85±6.46)u/l,(15.80±4.58)u/l in normal control group, Congenital Heart Disease with non-cardiac remodeling group,Congenital Heart Disease with cardiac remodeling group.The levels of ACE2protein contents showed significantly difference between normal control group and Congenital Heart Disease with non-cardiac remodeling group(P<0.05);The levels of ACE2protein contents showed no significant difference between normal control group and Congenital Heart Disease with cardiac remodeling group(P>0.05);The levels of ACE2protein contents showed significantly difference between Congenital Heart Disease with non-cardiac remodeling group and Congenital Heart Disease with cardiac remodeling group(P<0.01).6.The ACE2activity in plasma measured by activity colorimetric were(1.75±0.82)u/l, (1.75±0.62)u/l,(1.58±0.52)u/l in normal control group,Congenital Heart Disease with non-cardiac remodeling group,Congenital Heart Disease with cardiac remodeling group. There were no significantly differences among there groups(p>0.05).Conclusions:1.ACE2protein contents in the patients with Congenital Heart Disease combined with non-pulmonary hypertension have significantly increased.However,ACE2protein contents significantly declined according pulmonary arterial pressure increased.There was a negative correlation between Pulmonary arterial pressure and ACE2protein contents.2.ACE2activity significantly declined according pulmonary arterial pressure increased,especially ACE2activity in the patients with Congenital Heart Disease combined with severe pulmonary arterial hypertension have significantly declined.There was a negative correlation between Pulmonary arterial pressure and ACE2activity.3.ACE2protein contents in the patients with Congenital Heart Disease combined with non-cardiac remodeling have significantly increased.4.ACE2activity have no differences in the patients with Congenital Heart Disease combined with non-cardiac remodeling and Congenital Heart Disease combined with cardiac remodeling.