Evidence mapPaperPMID 35932065Full record

Trial reportCardiovascular diabetology2022

Glycated ACE2 reduces anti-remodeling effects of renin-angiotensin system inhibition in human diabetic hearts.

Raffaele Marfella, Nunzia D'Onofrio, Gelsomina Mansueto, Vincenzo Grimaldi, Maria Consiglia Trotta, Celestino Sardu, Ferdinando Carlo Sasso, Lucia Scisciola, Cristiano Amarelli, Salvatore Esposito and 12 more

Registry-linked trialOpen access · goldAbstract readClinical Trial
In one paragraph

Trial report in Cardiovascular diabetology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03546062 (Lipid Accumulation in Heart Transplant From Non-diabetic Donors to Diabetic Recipients), which is not on this map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03546062 completednot on this map

Lipid Accumulation in Heart Transplant From Non-diabetic Donors to Diabetic Recipients

TypeobservationalSponsorUniversity of Campania Luigi VanvitelliRan2010 to 2018Enrolled177ConditionsDiabetes Mellitus, Heart FailureArmspatients treated by HTx
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 21 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Article
  5. Article
  6. Review
  7. Review
  8. Article
  9. Terminal trajectory of HbAFrontiers in endocrinology · 2024
    Article
  10. Article
  11. The RAAS Goodfellas in Cardiovascular System.Journal of clinical medicine · 2023
    Review
  12. Article
  13. Review
  14. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 5 institutions in 2 countries.

Raffaele Marfella *Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy.
Nunzia D'Onofrio *Department of Precision Medicine, The University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
Gelsomina MansuetoDepartment of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy.
Vincenzo GrimaldiDepartment of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy.
Maria Consiglia TrottaDepartment of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
Celestino SarduDepartment of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy. drsarducele@gmail.com.
Ferdinando Carlo SassoDepartment of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy.
Lucia ScisciolaDepartment of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy.
Cristiano AmarelliUnit of Cardiac Surgery and Transplants, AORN Ospedali dei Colli-Monaldi Hospital, 80131, Naples, Italy.
Salvatore EspositoUnit of Pathological Anatomy, Aversa Hospital, Caserta, Italy.
Michele D'AmicoDepartment of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
Paolo GolinoCardiology Division, University "L. Vanvitelli" - Monaldi Hospital, 80131, Naples, Italy.
Marisa De FeoDepartment of Cardio-Thoracic Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Giuseppe SignorielloStatistical Unit-Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Pasquale PaolissoCardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
Emanuele GallinoroCardiology Division, University "L. Vanvitelli" - Monaldi Hospital, 80131, Naples, Italy.
Marc VanderheydenCardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
Ciro MaielloUnit of Cardiac Surgery and Transplants, AORN Ospedali dei Colli-Monaldi Hospital, 80131, Naples, Italy.
Maria Luisa BalestrieriDepartment of Experimental Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
Emanuele BarbatoCardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium.
Claudio Napoli *Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy.
Giuseppe Paolisso *Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Piazza Miraglia, 2, 80138, Naples, Italy.
University of Campania "Luigi Vanvitelli" · ITOspedale Monaldi · ITClinica Mediterranea · ITOnze Lieve Vrouwziekenhuis Hospital · BEUniversity of Naples Federico II · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh glycated-hemoglobin (HbA1c) levels correlated with an elevated risk of adverse cardiovascular outcomes despite renin-angiotensin system (RAS) inhibition in type-2 diabetic (T2DM) patients with reduced ejection fraction. Using the routine biopsies of non-T2DM heart transplanted (HTX) in T2DM recipients, we evaluated whether the diabetic milieu modulates glycosylated ACE2 (GlycACE2) levels in cardiomyocytes, known to be affected by non-enzymatic glycosylation, and the relationship with glycemic control.

objectivesWe investigated the possible effects of GlycACE2 on the anti-remodeling pathways of the RAS inhibitors by evaluating the levels of Angiotensin (Ang) 1-9, Ang 1-7, and Mas receptor (MasR), Nuclear-factor of activated T-cells (NFAT), and fibrosis in human hearts.

methodsWe evaluated 197 first HTX recipients (107 non-T2DM, 90 T2DM). All patients were treated with angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) at hospital discharge. Patients underwent clinical evaluation (metabolic status, echocardiography, coronary CT-angiography, and endomyocardial biopsies). Biopsies were used to evaluate ACE2, GlycACE2, Ang 1-9, Ang 1-7, MasR, NAFT, and fibrosis.

resultsGlycACE2 was higher in T2DM compared tonon-T2DM cardiomyocytes. Moreover, reduced expressions of Ang 1-9, Ang 1-7, and MasR were observed, suggesting impaired effects of RAS-inhibition in diabetic hearts. Accordingly, biopsies from T2DM recipients showed higher fibrosis than those from non-T2DM recipients. Notably, the expression of GlycACE2 in heart biopsies was strongly dependent on glycemic control, as reflected by the correlation between mean plasma HbA1c, evaluated quarterly during the 12-month follow-up, and GlycACE2 expression.

conclusionPoor glycemic control, favoring GlycACE2, may attenuate the cardioprotective effects of RAS-inhibition. However, the achievement of tight glycemic control normalizes the anti-remodeling effects of RAS-inhibition.

trial registrationhttps://clinicaltrials.gov/ NCT03546062.

Indexed as

Diabetes MellitusRenin-Angiotensin SystemAngiotensin-Converting Enzyme 2Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsFibrosisGlycated HemoglobinHumansPeptide FragmentsPeptidyl-Dipeptidase AAngiotensin-Converting Enzyme 2Angiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsGlycated HemoglobinPeptide FragmentsPeptidyl-Dipeptidase ADiabetesDiabetic cardiomyopathyHbA1cHeart transplantationRAS-inhibition therapy

Identifiers

PMID35932065
PMCPMC9356400
OpenAlexW4289932290

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.