Current Heart Failure Reports

, Volume 11, Issue 1, pp 58–63 | Cite as

Angiotensin-Converting Enzyme 2 as a Therapeutic Target for Heart Failure

  • Mohammed A. R. Chamsi-Pasha
  • Zhili Shao
  • W. H. Wilson Tang
Pharmacologic Therapy (WHW Tang, Section Editor)

Abstract

The renin-angiotensin system (RAS) plays a major role in the pathophysiology of cardiovascular disorders. Angiotensin II (Ang-II), the final product of this pathway, is known for its vasoconstrictive and proliferative effects. Angiotensin-converting enzyme 2 (ACE2), a newly discovered homolog of ACE, plays a key role as the central negative regulator of the RAS. It diverts the generation of vasoactive Ang-II into the vasodilatory and growth inhibiting peptide angiotensin(1–7) [Ang(1–7)], thereby providing counter-regulatory responses to neurohormonal activation. There is substantial experimental evidence evaluating the role of ACE2/Ang(1–7) in hypertension, heart failure, and atherosclerosis. In this review, we aim to focus on the conceptual facts of the ACE2-Ang(1–7) axis with regards to clinical implications and therapeutic targets in cardiovascular disorders, with emphasis on the potential therapeutic role in cardiovascular diseases.

Keywords

Renin angiotensin system Angiotensin converting enzyme 2 Angiotensin (1–7) Heart failure 

Abbreviations

ACE

angiotensin converting enzyme

ACE2

angiotensin converting enzyme2

Ang

Angiotensin

Ang(1–7)

Angiotensin-(1–7)

ARB

AT1 receptor blocker

AT1R

angiotensin receptor type 1

AT2

angiotensin receptor type 2

AVE 0991

Angiotensin-(1–7) Mas receptor agonist

CAD

coronary artery disease

HF

heart failure

LV

left ventricle

LVEF

left ventricular ejection fraction

NT-proBNP

N-terminal pro brain natriuretic peptide

NYHA

New York Heart Association

RAS

Renin Angiotensin System

rhACE2

recombinant human angiotensin converting enzymes 2

sACE2

soluble angiotensin-converting enzyme 2

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Mohammed A.R. Chamsi-Pasha declares that he has no conflict of interest.

Zhili Shao declares that he has no conflict of interest.

W.H.W. Wilson Tang is supported by National Institutes of Health grants R01HL103931 and P20HL113452, as well as grants from FoldRx Pharmaceuticals, Inc./Pfizer, Respicardia, Inc., and St. Jude Medical, Inc.; has received compensation from Medtronic, Inc., and St. Jude Medical, Inc. for service as a consultant.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Mohammed A. R. Chamsi-Pasha
    • 1
  • Zhili Shao
    • 2
  • W. H. Wilson Tang
    • 2
    • 3
  1. 1.Department of Cardiovascular MedicineUniversity of Nebraska Medical CenterOmahaUSA
  2. 2.Department of Cellular and Molecular Medicine, Cleveland ClinicLerner Research InstituteClevelandUSA
  3. 3.ClevelandUSA

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