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arameters Hypertensive and heart failure MedChemExpress SKI II patients had significantly enlarged initial left ventricular dimensions before cardiac resynchronization therapy compared to healthy individuals. Severe reduction of left ventricular pumping function was observed as represented by reduced EF in the CRT group. A significant decrease of ESD and EDD was found following 6 to 9 months of biventricular pacing. Pumping function also improved to a great extent in this group. The dP/dt parameter changed in a significant manner as well following CRT. N-Terminal Pro-Brain Natriuretic Peptide measurements NT-proBNP levels were measured in serum using a commercially available kit. Statistical analysis Unpaired echocardiographic values were analyzed by the nonparametric Kruskal-Wallis test. With these nonparametric tests there is a difference between the hypertensive and healthy patients groups. Bars are mean 6 S.E.M. Significant differences are labeled PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19645596 by asterisks. Paired echocardiographic data were evaluated by the nonparametric Wilcoxon matched-pairs signed rank test. The dP/dt parameter was analyzied with paired t-test. Statistical differences in the biochemical parameters were addressed by the parametric ANOVA tests. Linear regression analysis was performed to compare sACE2 activity with echocardiographic parameters and NT-proBNP levels. Linear regression analysis was performed to compare serum ACE concentration with echocardiographic parameters. P,0.05 was considered to be statistically significant for all the comparisons. All statistical analyses were performed using a commercially available software GraphPad Prism, version 4.0. sACE2 activity positively correlates with the clinical status of systolic heart failure patients A remarkable elevation of sACE2 activity was present in CRT patients before pacemaker implantation compared to healthy people and to the hypertensive patients with preserved left ventricular EF. Serum ACE2 activity strongly correlated with the clinical condition of patients with severe heart failure. The positive correlation between sACE2 and NYHA classes remained unchanged after pacemaker implantation, while the clinical status improved in most of the HF-patients. Angiotensin converting enzyme expression was generally lower in heart failure patients before CRT, but this general relationship disappeared after CRT. Results Baseline characteristics of study groups Clinical characteristics of the study groups are shown in sACE2 activity correlates with hypertension and with the deterioration of left ventricular systolic function Serum ACE2 activity correlated with the clinical status of HF. Accordingly, we performed a detailed study to identify serum ACE2 as a biomarker of human heart failure. Serum ACE2 activities were plotted as the function of systolic ejection fraction in all study groups. Serum ACE2 activities negatively correlated with EF in hypertensive patients similarly to HF patients. In contrast, no correlation was present between EF and sACE2 activity in healthy individuals. Moreover, a clear positive correlation was found between serum ACE2 activities and ESD and EDD in HF patients. sACE2 activity correlates with the improvement in left ventricular function Serum ACE2 activity was higher in hypertensive patients compared to healthy individuals and further increased in HF patients, suggesting that sACE2 activity may be a biomarker of cardiovascular disease or imminent heart failure. In Circulating ACE2 in Human Heart Failur