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Angiotensin‐converting enzyme inhibitor/angiotensin II receptor blocker treatment and haemodynamic factors are associated with increased cardiac mRNA expression of angiotensin‐converting enzyme 2 in patients with cardiovascular disease

European Journal of Heart Failure Nov 18, 2020

Lebek S, Tafelmeier M, Messmann R, et al. - Given that coronavirus disease 2019 (COVID‐19) represent a widespread pandemic with a raised morbidity and mortality, particularly for patients suffering from cardiovascular diseases, and that angiotensin‐converting enzyme 2 (ACE2) has been recognized as necessary cell entry point for severe acute respiratory syndrome coronavirus 2, researchers investigated how angiotensin‐converting enzyme inhibitors (ACEi)/angiotensin II receptor blockers (ARB) treatment can impact cardiac and white blood cellular ACE2 mRNA expression among high‐risk patients receiving heart surgery. This analysis involved 81 patients receiving coronary artery bypass grafting, in whom ACE2 mRNA expression was measured employing real‐time quantitative polymerase chain reaction in atrial biopsies. Comparison was performed between 62 patients that were given ACEi/ARB vs 19 patients that were not ACEi/ARB‐treated. Findings revealed an independent link between treatment with ACEi/ARB and a raised myocardial ACE2 mRNA expression among patients with coronary artery disease and in those with end‐stage heart failure. Further trials are required to determine if this link is deleterious for patients with COVID‐19, or likely protective. Haemodynamic factors appeared to be equally essential for regulation of cardiac ACE2 mRNA expression.

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