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Angiotensin II, III, and IV may be important in the progression of COVID-19. 血管紧张素II、III和IV可能在COVID-19的进展中很重要。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320972019
Erkan Cure, Tevfik Bulent Ilcol, Medine Cumhur Cure
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Dear Editor, The long-term consequences of SARS-CoV-2 infection and treatment of novel coronavirus disease 2019 (COVID19) are not yet known. Several drug studies have focused on the renin–angiotensin system (RAS) and angiotensin-converting enzyme 2 (ACE2). Angiotensin (Ang) II levels were found to be high in patients infected with SARS-CoV-2.1,2 The virus enters the cell after it binds to ACE2, as an ACE2– virus complex. The virus may alter ACE2 function and render the enzyme dysfunctional.2 Because the virus targets ACE2, treatments for COVID-19 may also need to target ACE2. In phase I and II studies and several case reports, recombinant ACE2 has been reported to improve the clinical course of patients with COVID-19 by increasing Ang II degradation.3–5 Along with Ang II, Ang III, and Ang IV may be responsible for severe forms of COVID-19. Ang II, a potent vasoconstrictor, triggers oxidative stress and inflammation. ACE2 converts Ang II to Ang 1–7 and Ang I to Ang 1–9.6 Ang 1–9 is one of the major products of the ACE pathway and is converted to Ang 1–7 by ACE and neprilysin.6,7 ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), statins, and some oral antidiabetics cause ACE2 upregulation.8 ACE2 upregulation increases the degradation of Ang II to Ang 1–7 and alamandine.9 Alamandine is a vasodilator peptide with anti-inflammatory and antiproliferative effects.9 ACE2 upregulation and an increase in Ang 1–7 and Ang 1–9 cause vasodilation and alleviate inflammation.10–12 Thus, increasing ACE2 and Ang 1–7 may contribute to the treatment of hypertension and diabetes, two critical comorbidities of COVID-19.13 Although an increase in the degradation of Ang II occurs in patients using ACEIs, Ang II formation continues through secondary pathways. Cathepsin G and kallikrein enzymes produce Ang II independently of ACE.14 ACE also breaks down bradykinin and, when ACE is blocked, bradykinin levels increase.15 Bradykinin activates the chymase pathway in tissues such as the heart and lung,15 allowing production of Ang II, Ang III, and Ang IV. The chymase pathway also generates Ang II from Ang 1–12.14 According to the results of a meta-analysis, ACEIs and ARBs do not adversely affect mortality rate and duration of hospital stay in patients with COVID-19.16 The metaanalysis indicated that ACEIs have a protective effect against COVID-19, but ARBs do not.16 However, in patients using ACEIs, Ang II formation continues through non-ACE pathways. The existence of alternative pathways for Ang II production and the increased
{"title":"Angiotensin II, III, and IV may be important in the progression of COVID-19.","authors":"Erkan Cure, Tevfik Bulent Ilcol, Medine Cumhur Cure","doi":"10.1177/1470320320972019","DOIUrl":"https://doi.org/10.1177/1470320320972019","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Dear Editor, The long-term consequences of SARS-CoV-2 infection and treatment of novel coronavirus disease 2019 (COVID19) are not yet known. Several drug studies have focused on the renin–angiotensin system (RAS) and angiotensin-converting enzyme 2 (ACE2). Angiotensin (Ang) II levels were found to be high in patients infected with SARS-CoV-2.1,2 The virus enters the cell after it binds to ACE2, as an ACE2– virus complex. The virus may alter ACE2 function and render the enzyme dysfunctional.2 Because the virus targets ACE2, treatments for COVID-19 may also need to target ACE2. In phase I and II studies and several case reports, recombinant ACE2 has been reported to improve the clinical course of patients with COVID-19 by increasing Ang II degradation.3–5 Along with Ang II, Ang III, and Ang IV may be responsible for severe forms of COVID-19. Ang II, a potent vasoconstrictor, triggers oxidative stress and inflammation. ACE2 converts Ang II to Ang 1–7 and Ang I to Ang 1–9.6 Ang 1–9 is one of the major products of the ACE pathway and is converted to Ang 1–7 by ACE and neprilysin.6,7 ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), statins, and some oral antidiabetics cause ACE2 upregulation.8 ACE2 upregulation increases the degradation of Ang II to Ang 1–7 and alamandine.9 Alamandine is a vasodilator peptide with anti-inflammatory and antiproliferative effects.9 ACE2 upregulation and an increase in Ang 1–7 and Ang 1–9 cause vasodilation and alleviate inflammation.10–12 Thus, increasing ACE2 and Ang 1–7 may contribute to the treatment of hypertension and diabetes, two critical comorbidities of COVID-19.13 Although an increase in the degradation of Ang II occurs in patients using ACEIs, Ang II formation continues through secondary pathways. Cathepsin G and kallikrein enzymes produce Ang II independently of ACE.14 ACE also breaks down bradykinin and, when ACE is blocked, bradykinin levels increase.15 Bradykinin activates the chymase pathway in tissues such as the heart and lung,15 allowing production of Ang II, Ang III, and Ang IV. The chymase pathway also generates Ang II from Ang 1–12.14 According to the results of a meta-analysis, ACEIs and ARBs do not adversely affect mortality rate and duration of hospital stay in patients with COVID-19.16 The metaanalysis indicated that ACEIs have a protective effect against COVID-19, but ARBs do not.16 However, in patients using ACEIs, Ang II formation continues through non-ACE pathways. The existence of alternative pathways for Ang II production and the increased ","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320972019"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320320972019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38584248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Effects of ACEI and ARB on COVID-19 patients: A meta-analysis. ACEI和ARB对COVID-19患者的影响:荟萃分析
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320981321
Yang Xue, Shaoqing Sun, Jianing Cai, Linwen Zeng, Shihui Wang, Suhuai Wang, Jingjie Li, Lin Sun, Jianmin Huo

Background: The clinical use of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin-receptor blockers (ARB) in patients with COVID-19 infection remains controversial. Therefore, we performed a meta-analysis on the effects of ACEI/ARB on disease symptoms and laboratory tests in hypertensive patients infected with COVID-19 virus and those who did not use ACEI/ARB.

Methods: We systematically searched the relevant literatures from Pubmed, Embase, EuropePMC, CNKI, and other databases during the study period of 31 December 2019 (solstice, 15 March 2020), and analyzed the differences in symptoms and laboratory tests between patients with COVID-19 and hypertension who used ACEI/ARB drugs and those who did not. All statistical analyses were performed with REVMAN5.3.

Results: We included a total of 1808 patients with hypertension diagnosed with COVID-19 in six studies. Analysis results show that ACEI/ARB drugs group D-dimer is lower (SMD = -0.22, 95%CI: -0.36 to -0.06), and the chances of getting fever is lower (OR = 0.74, 95%CI: 0.55 to 0.98). Meanwhile, laboratory data and symptoms were not statistical difference, but creatinine tends to rise (SMD = 0.22, 95% CI: 0.04 to 0.41).

Conclusion: We found that the administration of ACEI/ARB drugs had positive effect on reducing D-dimer and the number of people with fever. Meanwhile it had no significant effect on other laboratory tests (creatinine excepted) or symptoms in patients with COVID-19, while special attention was still needed in patients with renal insufficiency.

背景:血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB)在COVID-19感染患者中的临床应用仍存在争议。因此,我们对ACEI/ARB对感染COVID-19病毒的高血压患者和未使用ACEI/ARB的患者的疾病症状和实验室检查的影响进行了荟萃分析。方法:系统检索2019年12月31日(至2020年3月15日)期间Pubmed、Embase、EuropePMC、CNKI等数据库的相关文献,分析使用和未使用ACEI/ARB药物的COVID-19合并高血压患者在症状和实验室检查方面的差异。所有统计分析均采用REVMAN5.3进行。结果:我们在6项研究中共纳入了1808例诊断为COVID-19的高血压患者。分析结果显示,ACEI/ARB药物组d -二聚体较低(SMD = -0.22, 95%CI: -0.36 ~ -0.06),发热几率较低(OR = 0.74, 95%CI: 0.55 ~ 0.98)。同时,实验室数据和症状无统计学差异,但肌酐有升高趋势(SMD = 0.22, 95% CI: 0.04 ~ 0.41)。结论:我们发现ACEI/ARB药物对降低d -二聚体和发热人数有积极作用。同时对COVID-19患者的其他实验室检查(肌酐除外)和症状无显著影响,但对肾功能不全患者仍需特别注意。
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引用次数: 15
Haplotype-based association study between PRCP gene polymorphisms and essential hypertension in Hani minority group from a remote region of China. 中国偏远地区哈尼族人群PRCP基因多态性与原发性高血压的单倍型相关性研究
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320981316
Yanrui Wu, Xingming Pan, Xiaoxiao Jin

Objective: Prolylcarboxypeptidase (PRCP) is both involved in the Kallikrein-Kinin system (KKS) and renin-angiotensin-aldosterone system (RAAS). This study aimed to determine the genetic impact of PRCP gene polymorphisms on essential hypertension (EH) in an isolated population from a remote region of China.

Methods: A haplotype-based study was investigated in 346 EH patients and 346 normal subjects and all samples were Hani minority residents in Southwest China. A total of 11 tag single nucleotide polymorphisms (SNPs) in PRCP gene were tested by polymerase chain reaction-restriction fragment length polymorphism method.

Results: Single site analysis found that PRCP gene 3'UTR SNP rs3750931 was associated with EH. The minor allele G of rs3750931 was more prevalent in the EH patients compared to control subjects after Bonferroni correction (p < 0.05). Moreover, the rs3750931 G allele carriers showed higher average blood pressure (BP) level among the subjects. The H2 (GAGCACTAACA) haplotype without rs3750931 G allele showed the protective effect for EH (OR = 0.68, 95 CI 0.54-0.85, p = 0.001).

Conclusion: The present study indicated PRCP gene rs3750931 was associated with the risk of EH. This SNP G allele could be considered as one of risk markers for EH in Hani population.

目的:prolycarboxypeptidase (PRCP)是一种既参与钾likrein- kinin系统(KKS)又参与肾素-血管紧张素-醛固酮系统(RAAS)的酶。本研究旨在确定PRCP基因多态性对中国偏远地区孤立人群原发性高血压(EH)的遗传影响。方法:对346例EH患者和346例正常人进行单倍型研究,样本均为西南地区哈尼族居民。采用聚合酶链反应-限制性片段长度多态性法检测了PRCP基因11个标签单核苷酸多态性(snp)。结果:单位点分析发现PRCP基因3'UTR SNP rs3750931与EH相关。经Bonferroni校正后,EH患者中rs3750931的小等位基因G比对照组更普遍(p p = 0.001)。结论:PRCP基因rs3750931与EH发生风险相关。该SNP G等位基因可作为哈尼族人群EH的危险标志之一。
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引用次数: 0
The value of the post-captopril aldosterone/renin ratio for the diagnosis of primary aldosteronism and the influential factors: A meta-analysis. 卡托普利后醛固酮/肾素比值对原发性醛固酮增多症的诊断价值及其影响因素:荟萃分析。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320972032
Qiao Xiang, Wen Wang, Tao Chen, Kai Yu, Qianrui Li, Tingting Zhang, Haoming Tian, Yan Ren

Objective: The procedure for the captopril challenge test (CCT) in diagnosing primary aldosteronism (PA) is not standardized. We performed a meta-analysis to evaluate the controversial diagnostic value and influential factors of the post-captopril aldosterone/renin ratio (ARR).

Methods: We searched literature in databases for eligible studies (until October 1, 2020). We extracted information regarding study and patient characteristics, CCT methods, outcome data. We pooled studies using the random-effect model. We performed meta-regression and six pre-specified subgroup analyses to explore heterogeneity.

Results: Nineteen studies involving 4568 subjects were included. The pooled sensitivity and specificity were 0.825 (95% CI 0.804-0.844) and 0.919 (95% CI 0.908-0.928). The area under the summary receiver operating characteristic curve was 0.9487 (95% CI 0.9207-0.9767). Meta-regression revealed that heterogeneity might derive from time interval (p = 0.0117) and study population (p = 0.0033). Subgroup analyses showed significant differences between the subgroups stratified by the dose, posture, study region, time interval, cut-off value and study population for sensitivity and/or specificity (p < 0.05).

Conclusion: Post-captopril ARR is comparably valuable for diagnosing PA at cut-offs from 12.0 to 50.0. Conducting the CCT in the supine position with 25 mg of captopril may attain greater sensitivity. Conducting the CCT in the seated position with 50 mg of captopril may attain greater specificity. A 90-min time interval may perform best in both the sensitivity and specificity.

目的:卡托普利激发试验(CCT)诊断原发性醛固酮增多症(PA)的方法尚不规范。我们进行了一项荟萃分析,以评估卡托普利后醛固酮/肾素比值(ARR)有争议的诊断价值和影响因素。方法:我们在数据库中检索符合条件的研究文献(截至2020年10月1日)。我们提取了有关研究和患者特征、CCT方法、结果数据的信息。我们使用随机效应模型汇总研究。我们进行了meta回归和六个预先指定的亚组分析来探索异质性。结果:共纳入19项研究,4568名受试者。合并敏感性和特异性分别为0.825 (95% CI 0.804-0.844)和0.919 (95% CI 0.908-0.928)。总体受试者工作特征曲线下面积为0.9487 (95% CI 0.9207 ~ 0.9767)。meta回归显示异质性可能来源于时间间隔(p = 0.0117)和研究人群(p = 0.0033)。亚组分析显示,按剂量、体位、研究区域、时间间隔、临界值和研究人群对敏感性和/或特异性进行分层的亚组之间存在显著差异(p结论:卡托普利后ARR在12.0至50.0的临界值对诊断PA具有相当的价值。仰卧位使用25mg卡托普利进行CCT可获得更高的灵敏度。用50mg卡托普利坐位行CCT可获得更大的特异性。在敏感性和特异性方面,90分钟的时间间隔可达到最佳效果。
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引用次数: 4
Central involvement of SARS-CoV-2 may aggravate ARDS and hypertension. SARS-CoV-2的中枢性受累可能加重急性呼吸窘迫综合征和高血压。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320972015
Erkan Cure, Medine Cumhur Cure, Hulya Vatansev
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Dear Sir, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread rapidly all over the world; however, the mechanism of the disease is not yet fully understood. Why do many people who come into contact with the virus not get sick and remain asymptomatic? Why do some people recover with tiny symptoms, while other people have a severe infection or die? SARSCoV-2 infection can lead to severe or fatal outcomes in patients with comorbid diseases such as hypertension, diabetes, obesity, and heart failure. SARS-CoV-2 binds to angiotensin-converting enzyme (ACE)-2, like SARS-CoV, enters the cells and causes infection. The renin-angiotensin system (RAS) plays a crucial role in the virus entry to cells and the progression of the virus-induced disease. Whether ACE2 upregulation will increase viral load remains unclear.1 ACE2 up-regulation increases angiotensin 1–7 formation and may have a protective effect against SARSCOV-2 caused acute respiratory distress syndrome (ARDS) and heart damage.1 Angiotensin II level is high in patients with the novel coronavirus disease 2019 (COVID19). According to an extensive view, SARS-CoV-2 binds to ACE2, causing ACE2 to become dysfunctional.2 Therefore, increased angiotensin II level leads to ARDS and heart damage.2 Interestingly, most infected people have no symptoms, and they do not have heart or lung damage. The effects of SARS-CoV-2 on peripheral RAS have been highlighted so far. We believe that the central RAS involvement of the virus has vital implications for COVID-19 progression. Regulation of pulmonary vascular tone is vital for the maintenance of pulmonary functions. RAS regulates vasoconstriction and vasodilation of the pulmonary vascular system. Bradykinin and kinin are responsible for the permeability and vasodilation of the pulmonary vascular system (Figure 1). Inflammation leads to an increase in bradykinin-1 receptor (B1R) in the lungs. They increase vascular permeability by binding bradykinin to the bradykinin-2 receptor (B2R) and des-arg9-bradykinin binding to the B1R. Increased pulmonary vascular permeability causes pulmonary edema.3,4 SARS-CoV-2 can cause ARDS via the bradykinin pathway in the lung (Figure 1).3,4 The brain is one of the tissues containing ACE2, such as the lung, heart, pancreas, kidney, and vascular endothelium, and SARS-CoV-2 can easily infect the brain.5,6 The virus infects the brain after can cross the blood-brain barrier either by direct transport through the bloodstream or indirectly by binding to the vascular endotheliu
{"title":"Central involvement of SARS-CoV-2 may aggravate ARDS and hypertension.","authors":"Erkan Cure,&nbsp;Medine Cumhur Cure,&nbsp;Hulya Vatansev","doi":"10.1177/1470320320972015","DOIUrl":"https://doi.org/10.1177/1470320320972015","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Dear Sir, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread rapidly all over the world; however, the mechanism of the disease is not yet fully understood. Why do many people who come into contact with the virus not get sick and remain asymptomatic? Why do some people recover with tiny symptoms, while other people have a severe infection or die? SARSCoV-2 infection can lead to severe or fatal outcomes in patients with comorbid diseases such as hypertension, diabetes, obesity, and heart failure. SARS-CoV-2 binds to angiotensin-converting enzyme (ACE)-2, like SARS-CoV, enters the cells and causes infection. The renin-angiotensin system (RAS) plays a crucial role in the virus entry to cells and the progression of the virus-induced disease. Whether ACE2 upregulation will increase viral load remains unclear.1 ACE2 up-regulation increases angiotensin 1–7 formation and may have a protective effect against SARSCOV-2 caused acute respiratory distress syndrome (ARDS) and heart damage.1 Angiotensin II level is high in patients with the novel coronavirus disease 2019 (COVID19). According to an extensive view, SARS-CoV-2 binds to ACE2, causing ACE2 to become dysfunctional.2 Therefore, increased angiotensin II level leads to ARDS and heart damage.2 Interestingly, most infected people have no symptoms, and they do not have heart or lung damage. The effects of SARS-CoV-2 on peripheral RAS have been highlighted so far. We believe that the central RAS involvement of the virus has vital implications for COVID-19 progression. Regulation of pulmonary vascular tone is vital for the maintenance of pulmonary functions. RAS regulates vasoconstriction and vasodilation of the pulmonary vascular system. Bradykinin and kinin are responsible for the permeability and vasodilation of the pulmonary vascular system (Figure 1). Inflammation leads to an increase in bradykinin-1 receptor (B1R) in the lungs. They increase vascular permeability by binding bradykinin to the bradykinin-2 receptor (B2R) and des-arg9-bradykinin binding to the B1R. Increased pulmonary vascular permeability causes pulmonary edema.3,4 SARS-CoV-2 can cause ARDS via the bradykinin pathway in the lung (Figure 1).3,4 The brain is one of the tissues containing ACE2, such as the lung, heart, pancreas, kidney, and vascular endothelium, and SARS-CoV-2 can easily infect the brain.5,6 The virus infects the brain after can cross the blood-brain barrier either by direct transport through the bloodstream or indirectly by binding to the vascular endotheliu","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320972015"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320320972015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38592575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Impact of contrast-induced acute kidney injury on the association between renin-angiotensin system inhibitors and long-term mortality in heart failure patients. 造影剂诱导的急性肾损伤对心力衰竭患者肾素-血管紧张素系统抑制剂与长期死亡率之间关系的影响。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320979795
Li Lei, Yulu Huang, Zhaodong Guo, Feier Song, Yibo He, Jin Liu, Guoli Sun, Bowen Liu, Pengyuan Chen, Jianbin Zhao, Dengxuan Wu, Yan Xue, Wenhe Yan, Zefeng Lin, Xiuqiong Huang, Guanzhong Chen, Shiqun Chen, Yong Liu, Jiyan Chen

Introduction: Renin-angiotensin system inhibitors (RASi) reduce mortality among heart failure (HF) patients, but their effect among those complicating contrast-induced acute kidney injury (CI-AKI) remains unexplored. We aimed to investigate whether the relationship between RASi prescription at discharge and mortality differs between HF patients with or without CI-AKI following coronary angiography (CAG).

Methods: About 596 HF patients from an observational cohort were divided into a CI-AKI group (n = 104) and a non-CI-AKI group (n = 492) based on whether they had CI-AKI following CAG. The endpoint was all-cause mortality. Multivariable Cox regression was performed in each group to explore the associations between RASi at discharge and mortality.

Results: During the median follow-up time of 2.26 (1.70; 3.24) years, higher mortality rate was observed in the CI-AKI group compared to the non-CI-AKI group (18.3% vs 8.9%, p = 0.002). Among HF patients with CI-AKI, after adjusting for confounding factors, the association was not significant between RASi prescription at discharge and mortality (HR: 0.39, 95%CI: 0.12-1.31, p = 0.128), while it was among those without CI-AKI (HR: 0.39, 95%CI: 0.18-0.84, p = 0.016).

Conclusion: RASi prescription at discharge for HF patients complicating CI-AKI tended to be ineffective, while it benefited those without CI-AKI. Further randomized evidence is needed to confirm this trend.

导论:肾素-血管紧张素系统抑制剂(RASi)可降低心力衰竭(HF)患者的死亡率,但其在合并造反差剂诱导的急性肾损伤(CI-AKI)患者中的作用仍未研究。我们的目的是研究在有或没有冠状动脉造影(CAG)的HF患者中,出院时RASi处方与死亡率之间的关系是否不同。方法:根据CAG后是否有CI-AKI,将596例HF患者分为CI-AKI组(n = 104)和非CI-AKI组(n = 492)。终点是全因死亡率。对每组进行多变量Cox回归,探讨出院时RASi与死亡率之间的关系。结果:中位随访时间为2.26 (1.70;3.24)年,CI-AKI组的死亡率高于非CI-AKI组(18.3% vs 8.9%, p = 0.002)。在合并CI-AKI的HF患者中,校正混杂因素后,出院时RASi处方与死亡率的相关性不显著(HR: 0.39, 95%CI: 0.12-1.31, p = 0.128),而在未合并CI-AKI的HF患者中相关性显著(HR: 0.39, 95%CI: 0.18-0.84, p = 0.016)。结论:对于合并CI-AKI的HF患者,出院时开具RASi处方往往无效,而对未合并CI-AKI的患者则有利。需要进一步的随机证据来证实这一趋势。
{"title":"Impact of contrast-induced acute kidney injury on the association between renin-angiotensin system inhibitors and long-term mortality in heart failure patients.","authors":"Li Lei,&nbsp;Yulu Huang,&nbsp;Zhaodong Guo,&nbsp;Feier Song,&nbsp;Yibo He,&nbsp;Jin Liu,&nbsp;Guoli Sun,&nbsp;Bowen Liu,&nbsp;Pengyuan Chen,&nbsp;Jianbin Zhao,&nbsp;Dengxuan Wu,&nbsp;Yan Xue,&nbsp;Wenhe Yan,&nbsp;Zefeng Lin,&nbsp;Xiuqiong Huang,&nbsp;Guanzhong Chen,&nbsp;Shiqun Chen,&nbsp;Yong Liu,&nbsp;Jiyan Chen","doi":"10.1177/1470320320979795","DOIUrl":"https://doi.org/10.1177/1470320320979795","url":null,"abstract":"<p><strong>Introduction: </strong>Renin-angiotensin system inhibitors (RASi) reduce mortality among heart failure (HF) patients, but their effect among those complicating contrast-induced acute kidney injury (CI-AKI) remains unexplored. We aimed to investigate whether the relationship between RASi prescription at discharge and mortality differs between HF patients with or without CI-AKI following coronary angiography (CAG).</p><p><strong>Methods: </strong>About 596 HF patients from an observational cohort were divided into a CI-AKI group (<i>n</i> = 104) and a non-CI-AKI group (<i>n</i> = 492) based on whether they had CI-AKI following CAG. The endpoint was all-cause mortality. Multivariable Cox regression was performed in each group to explore the associations between RASi at discharge and mortality.</p><p><strong>Results: </strong>During the median follow-up time of 2.26 (1.70; 3.24) years, higher mortality rate was observed in the CI-AKI group compared to the non-CI-AKI group (18.3% vs 8.9%, <i>p</i> = 0.002). Among HF patients with CI-AKI, after adjusting for confounding factors, the association was not significant between RASi prescription at discharge and mortality (HR: 0.39, 95%CI: 0.12-1.31, <i>p</i> = 0.128), while it was among those without CI-AKI (HR: 0.39, 95%CI: 0.18-0.84, <i>p</i> = 0.016).</p><p><strong>Conclusion: </strong>RASi prescription at discharge for HF patients complicating CI-AKI tended to be ineffective, while it benefited those without CI-AKI. Further randomized evidence is needed to confirm this trend.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320979795"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320320979795","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38373375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Countermeasure and therapeutic: A(1-7) to treat acute respiratory distress syndrome due to COVID-19 infection. 对策与治疗:A(1-7)治疗COVID-19感染急性呼吸窘迫综合征。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320972018
Maira Soto, Gere diZerega, Kathleen E Rodgers

In the wake of the COVID-19 pandemic it has become clear that there is a need for therapies that are capable of reducing damage caused to patients from infections. Infections that induce Acute Respiratory Distress Syndrome (ARDS) are especially devastating because lung damage is so critical and difficult to manage. Angiotensin (1-7) [A(1-7)] has already been shown to protect pulmonary health and architecture in various models of disease. There is also evidence that A(1-7) can modulate immune function and protect various organs (lung, kidney, and heart) from oxidative damage and inflammation. Here we focus on making a case for the development of novel therapies that target the protective arm of the Renin Angiotensin System (RAS).

在2019冠状病毒病大流行之后,很明显,需要能够减少感染对患者造成损害的治疗方法。引起急性呼吸窘迫综合征(ARDS)的感染尤其具有破坏性,因为肺损伤非常严重且难以控制。血管紧张素(1-7)[A(1-7)]已被证明在各种疾病模型中保护肺部健康和结构。也有证据表明,A(1-7)可以调节免疫功能,保护各种器官(肺、肾和心脏)免受氧化损伤和炎症。在这里,我们专注于开发针对肾素血管紧张素系统(RAS)保护臂的新疗法。
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引用次数: 7
Angiotensin-converting enzyme 2, the complement system, the kallikrein-kinin system, type-2 diabetes, interleukin-6, and their interactions regarding the complex COVID-19 pathophysiological crossroads. 血管紧张素转换酶2、补体系统、钾化钾素-激肽系统、2型糖尿病、白细胞介素-6及其在复杂的COVID-19病理生理十字路口中的相互作用。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320979097
Martijn Hoevenaar, Dolf Goossens, Janne Roorda

Because of the current COVID-19-pandemic, the world is currently being held hostage in various lockdowns. ACE2 facilitates SARS-CoV-2 cell-entry, and is at the very center of several pathophysiological pathways regarding the RAAS, CS, KKS, T2DM, and IL-6. Their interactions with severe COVID-19 complications (e.g. ARDS and thrombosis), and potential therapeutic targets for pharmacological intervention, will be reviewed.

由于当前的covid -19大流行,世界目前正处于各种封锁之中。ACE2促进SARS-CoV-2细胞进入,是RAAS、CS、KKS、T2DM和IL-6等几种病理生理通路的核心。它们与COVID-19严重并发症(如ARDS和血栓形成)的相互作用以及药物干预的潜在治疗靶点将被回顾。
{"title":"Angiotensin-converting enzyme 2, the complement system, the kallikrein-kinin system, type-2 diabetes, interleukin-6, and their interactions regarding the complex COVID-19 pathophysiological crossroads.","authors":"Martijn Hoevenaar, Dolf Goossens, Janne Roorda","doi":"10.1177/1470320320979097","DOIUrl":"10.1177/1470320320979097","url":null,"abstract":"<p><p>Because of the current COVID-19-pandemic, the world is currently being held hostage in various lockdowns. ACE2 facilitates SARS-CoV-2 cell-entry, and is at the very center of several pathophysiological pathways regarding the RAAS, CS, KKS, T2DM, and IL-6. Their interactions with severe COVID-19 complications (e.g. ARDS and thrombosis), and potential therapeutic targets for pharmacological intervention, will be reviewed.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320979097"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320320979097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38343724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
The genetic polymorphisms of angiotensin converting enzyme insertion/deletion and glioma susceptibility: A meta-analysis. 血管紧张素转换酶插入/缺失与胶质瘤易感性的遗传多态性:一项荟萃分析。
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320963939
Meili Sun, Yuying Fang, Shuzhen Ma, Ximei Gao, Yuping Sun

Objective: The previous studies on angiotensin converting enzyme (ACE) insertion/deletion (I/D) genetic polymorphism and glioma risk were inconsistent. Therefore, we performed a meta-analysis to assess the association between ACE I/D polymorphisms and glioma risk.

Methods and results: In total, four populations (1110 cases and 1335 controls) on ACE I/D polymorphism were included. Overall, the meta-analysis demonstrated no significant association between ACE I/D polymorphism and glioma risk. In addition, the analysis of the association of ACE I/D polymorphism and clinical grade also showed no significant association.

Conclusion: Our meta-analysis didn't find a significant association between ACE I/D polymorphism glioma risk. However, further studies with larger sample size and more ethnic groups are required to confirm the results.

目的:血管紧张素转换酶(ACE)插入/缺失(I/D)基因多态性与神经胶质瘤发病风险的研究不一致。因此,我们进行了一项荟萃分析来评估ACE I/D多态性与胶质瘤风险之间的关系。方法与结果:共纳入4个人群(1110例和1335例对照)的ACE I/D多态性。总的来说,荟萃分析显示ACE I/D多态性与胶质瘤风险之间没有显著关联。此外,对ACE I/D多态性与临床分级的相关性分析也显示无显著相关性。结论:我们的荟萃分析没有发现ACE I/D多态性与胶质瘤风险之间的显著关联。然而,需要进一步的更大样本量和更多种族的研究来证实这一结果。
{"title":"The genetic polymorphisms of angiotensin converting enzyme insertion/deletion and glioma susceptibility: A meta-analysis.","authors":"Meili Sun,&nbsp;Yuying Fang,&nbsp;Shuzhen Ma,&nbsp;Ximei Gao,&nbsp;Yuping Sun","doi":"10.1177/1470320320963939","DOIUrl":"https://doi.org/10.1177/1470320320963939","url":null,"abstract":"<p><strong>Objective: </strong>The previous studies on angiotensin converting enzyme (ACE) insertion/deletion (I/D) genetic polymorphism and glioma risk were inconsistent. Therefore, we performed a meta-analysis to assess the association between ACE I/D polymorphisms and glioma risk.</p><p><strong>Methods and results: </strong>In total, four populations (1110 cases and 1335 controls) on ACE I/D polymorphism were included. Overall, the meta-analysis demonstrated no significant association between ACE I/D polymorphism and glioma risk. In addition, the analysis of the association of ACE I/D polymorphism and clinical grade also showed no significant association.</p><p><strong>Conclusion: </strong>Our meta-analysis didn't find a significant association between ACE I/D polymorphism glioma risk. However, further studies with larger sample size and more ethnic groups are required to confirm the results.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320963939"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1470320320963939","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38478908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Angiotensinogen M235T polymorphism and susceptibility to hypertrophic cardiomyopathy in Asian population: A meta analysis. 亚洲人血管紧张素原 M235T 多态性与肥厚型心肌病的易感性:荟萃分析
IF 2.9 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-01 DOI: 10.1177/1470320320978100
Zhen Zhen, Lu Gao, Qin Wang, Xi Chen, Jia Na, Xiwei Xu, Yue Yuan

Objective: To explore the relationship between the polymorphism of angiotensinogen gene (AGT) M235T and susceptibility to hypertrophic cardiomyopathy (HCM) in Asian population by meta-analysis.

Methods: PubMed, Embase, Web of Science, Cochrane library, CNKI, Wan Fang, and other databases were searched to collect the literature about AGT M235T polymorphism and HCM from the inception to March 1, 2020. The Newcastle-Ottawa Scale (NOS) checklist was uesd to perform independent literature review and study quality assessment. Data was analyzed by Stata 15.0 software.

Results: The results showed that, except for the recessive genetic model (TT vs MT+MM: OR = 1.27, 95%CI: 1.05-1.53), in the other four genetic models, the M235T polymorphism had no significant correlation with the risk of HCM (T vs M: OR = 1.17, 95%CI: 0.88-1.57; TT+MT vs MM: OR = 1.13, 95%CI: 0.55-2.33; TT vs MM: OR = 1.25, 95%CI: 0.60-2.59; TM vs MM: OR = 0.95, 95%CI0.5-1.82). The results of subgroup analysis showed that, except for the heterozygous genetic model, in the other four genetic models, M235T polymorphism was significantly associated with sporadic hypertrophic cardiomyopathy (SHCM), but not with familial hypertrophic cardiomyopathy (FHCM) (p > 0.05).

Conclusion: M235T polymorphism in Asians is associated with HCM, especially SHCM. Heterozygotes increase the risk of patients with SHCM.

目的通过荟萃分析探讨亚洲人群血管紧张素原基因(AGT)M235T多态性与肥厚型心肌病(HCM)易感性之间的关系:方法:检索PubMed、Embase、Web of Science、Cochrane library、CNKI、万方等数据库,收集从开始到2020年3月1日有关AGT M235T多态性与HCM的文献。采用纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)核对表进行独立文献综述和研究质量评估。数据由 Stata 15.0 软件进行分析:结果显示,除隐性遗传模型(TT vs MT+MM:OR = 1.27,95%CI:1.05-1.53)外,在其他四种遗传模型中,M235T 多态性与 HCM 风险无显著相关性(T vs M:OR = 1.17,95%CI:0.88-1.57;TT+MT vs MM:OR = 1.13,95%CI:0.55-2.33;TT vs MM:OR = 1.25,95%CI:0.60-2.59;TM vs MM:OR = 0.95,95%CI0.5-1.82)。亚组分析结果显示,除了杂合子遗传模式外,在其他四种遗传模式中,M235T 多态性与散发性肥厚型心肌病(SHCM)显著相关,但与家族性肥厚型心肌病(FHCM)无关(P > 0.05):结论:亚洲人的 M235T 多态性与 HCM(尤其是 SHCM)有关。结论:亚洲人的 M235T 多态性与 HCM(尤其是 SHCM)有关,杂合子会增加 SHCM 患者的风险。
{"title":"Angiotensinogen M235T polymorphism and susceptibility to hypertrophic cardiomyopathy in Asian population: A meta analysis.","authors":"Zhen Zhen, Lu Gao, Qin Wang, Xi Chen, Jia Na, Xiwei Xu, Yue Yuan","doi":"10.1177/1470320320978100","DOIUrl":"10.1177/1470320320978100","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between the polymorphism of angiotensinogen gene (AGT) M235T and susceptibility to hypertrophic cardiomyopathy (HCM) in Asian population by meta-analysis.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, Cochrane library, CNKI, Wan Fang, and other databases were searched to collect the literature about AGT M235T polymorphism and HCM from the inception to March 1, 2020. The Newcastle-Ottawa Scale (NOS) checklist was uesd to perform independent literature review and study quality assessment. Data was analyzed by Stata 15.0 software.</p><p><strong>Results: </strong>The results showed that, except for the recessive genetic model (TT vs MT+MM: OR = 1.27, 95%CI: 1.05-1.53), in the other four genetic models, the M235T polymorphism had no significant correlation with the risk of HCM (T vs M: OR = 1.17, 95%CI: 0.88-1.57; TT+MT vs MM: OR = 1.13, 95%CI: 0.55-2.33; TT vs MM: OR = 1.25, 95%CI: 0.60-2.59; TM vs MM: OR = 0.95, 95%CI0.5-1.82). The results of subgroup analysis showed that, except for the heterozygous genetic model, in the other four genetic models, M235T polymorphism was significantly associated with sporadic hypertrophic cardiomyopathy (SHCM), but not with familial hypertrophic cardiomyopathy (FHCM) (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>M235T polymorphism in Asians is associated with HCM, especially SHCM. Heterozygotes increase the risk of patients with SHCM.</p>","PeriodicalId":17330,"journal":{"name":"Journal of the Renin-Angiotensin-Aldosterone System","volume":"21 4","pages":"1470320320978100"},"PeriodicalIF":2.9,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/43/10.1177_1470320320978100.PMC7734517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38696739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of the Renin-Angiotensin-Aldosterone System
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