Frontiers in medicine · 2026
Differential expression and clinical significance of angiotensin (1-7)/Ang II and Elabela/Ang II ratios in patients with acute heart failure and type I cardiorenal syndrome.
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Zheng Mengdi, Chen Biqi, Zhou Yang, He Ruiyang, Wang Zhi
Аннотация
INTRODUCTION: This study assesses the serum levels of Elabela (ELA/Apela) and apelin receptor (APJ), angiotensin II (Ang II) and angiotensin-converting enzyme (ACE), as well as Ang (1-7) and ACE2, in patients with acute heart failure (AHF) and type I cardiorenal syndrome (CRS).
METHODS: A total of 31 AHF patients, 38 type I CRS patients and 31 healthy controls were enrolled. Serum concentrations of ELA, APJ, Ang II, ACE, Ang (1-7) and ACE2 were measured using ELISA. ROC curves were used to assess the diagnostic performance of the ratios of Ang (1-7)/Ang II and ELA/Ang II for AHF and type I CRS.
RESULTS: The mean ratios of Ang (1-7)/Ang II and ELA/Ang II increased in both AHF and CRS groups compared to the control group. However, the ratio of ELA/Ang II significantly decreased in the CRS group compared to the AHF group. The ratio of ELA/Ang II negatively correlated with creatinine and positively correlated with eGFR in CRS patients. The AUC for Ang (1-7)/Ang II in diagnosing AHF and type I CRS was 0.7128 and 0.6978, respectively. The AUC for ELA/Ang II in diagnosing AHF and type I CRS was 0.8783 and 0.7530, respectively.
CONCLUSION: The ELA/Ang II ratio can be used as an additional indicator for diagnosing AHF or type I CRS. Although the ELA/Ang II ratio is particularly well correlated with eGFR in patients with type I CRS, the value of the ratio in evaluating the degree of renal impairment in these patients remains to be further studied.
METHODS: A total of 31 AHF patients, 38 type I CRS patients and 31 healthy controls were enrolled. Serum concentrations of ELA, APJ, Ang II, ACE, Ang (1-7) and ACE2 were measured using ELISA. ROC curves were used to assess the diagnostic performance of the ratios of Ang (1-7)/Ang II and ELA/Ang II for AHF and type I CRS.
RESULTS: The mean ratios of Ang (1-7)/Ang II and ELA/Ang II increased in both AHF and CRS groups compared to the control group. However, the ratio of ELA/Ang II significantly decreased in the CRS group compared to the AHF group. The ratio of ELA/Ang II negatively correlated with creatinine and positively correlated with eGFR in CRS patients. The AUC for Ang (1-7)/Ang II in diagnosing AHF and type I CRS was 0.7128 and 0.6978, respectively. The AUC for ELA/Ang II in diagnosing AHF and type I CRS was 0.8783 and 0.7530, respectively.
CONCLUSION: The ELA/Ang II ratio can be used as an additional indicator for diagnosing AHF or type I CRS. Although the ELA/Ang II ratio is particularly well correlated with eGFR in patients with type I CRS, the value of the ratio in evaluating the degree of renal impairment in these patients remains to be further studied.