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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 Feb 14, 2021

Lebek S, Tafelmeier M, Messmann R, et al. - Given that angiotensin‐converting enzyme 2 (ACE2) has been recognized as necessary cell entry point for severe acute respiratory syndrome coronavirus 2, and a raised ACE2 expression after treatment with either angiotensin‐converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) has been shown in previous animal studies resulting in a massive precariousness concerning the optimal cardiovascular therapy during coronavirus disease 2019 (COVID‐19) pandemic, researchers herein addressed this topic. They assessed ACE2 mRNA expression in atrial biopsies of 81 patients receiving coronary artery bypass grafting and also performed comparison between 62 patients treated with ACEi/ARB vs 19 patients that did not receive ACEi/ARB. Findings revealed an independent association of ACEi/ARB treatment with an increased myocardial ACE2 mRNA expression in patients with coronary artery disease as well as in those suffering from end‐stage heart failure. To determine if this link is detrimental for COVID‐19 patients, or probably protective, there is a requirement of further trials. Nevertheless, haemodynamic factors appeared to be equally essential for regulation of cardiac ACE2 mRNA expression.

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