Abstract：
BACKGROUND:Blockade of the renin-angiotensin system (RAS) represents a main strategy in the therapy of heart failure with reduced ejection fraction (HFrEF), but the role of active renin concentration (ARC) for guiding therapy in the presence of an RAS blockade remains to be established. This study assessed angiotensin profiles of HFrEF patients with distinct RAS activations as reflected by ARC. METHODS:Two cohorts of stable chronic HFrEF patients on optimal medical treatment (OMT) were enrolled. We assessed ARC and all known circulating angiotensin metabolites, including AngI and AngII, by mass spectrometry to investigate the effect of different therapy modalities. Low- and high-renin HFrEF patients were identified by ARC screening and subsequently characterized by their angiotensin profiles. RESULTS:Although different modes of RAS blockade resulted in typical AngII/AngI ratios, concentrations of (AngI+AngII) strongly correlated with ARC [r = 0.95, P < 0.001] independent of therapy mode. Despite RAS blocker treatment with angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II type 1 receptor blockers (ARB), which anticipated ARC upregulation, about 30% of patients showed lower/normal range ARC values. ARC did not correlate with N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations and New York Heart Association (NYHA) stages. Angiotensin concentrations were profoundly diminished for the low-ARC group compared with the high-ARC group: AngI [6.4 ng/L (IQR: 2.1-12.5) vs 537.9 ng/L (IQR: 423.1-728.4), P < 0.001 for ACE-I; and 4.5 ng/L (IQR: 1.4-11.2) vs 203.0 ng/L (IQR: 130.2-247.9), P = 0.003 for ARB] and AngII [<1.4 ng/L (IQR: <1.4-1.5) vs 6.1 ng/L (IQR: 2.0-11.1), P = 0.002 for ACE-I and 4.7 ng/L (IQR: <1.4-12.3) vs 206.4 ng/L (IQR: 142.2-234.4), P < 0.001 for ARB]. CONCLUSIONS:In addition to NT-proBNP and NYHA stages, ARC enables classification of HFrEF patients receiving OMT into more distinguished neurohumoral HFrEF phenotypes, offering a rationale for adaptive therapeutic interventions.
journal_name
Clin Chemjournal_title
Clinical chemistryauthors
Pavo N,Goliasch G,Wurm R,Novak J,Strunk G,Gyöngyösi M,Poglitsch M,Säemann MD,Hülsmann Mdoi
10.1373/clinchem.2017.278705subject
Has Abstractpub_date
2018-03-01 00:00:00pages
597-608issue
3eissn
0009-9147issn
1530-8561pii
clinchem.2017.278705journal_volume
64pub_type
杂志文章abstract：:We describe a method for measuring apolipoprotein (apo) C distribution between apo B-containing lipoprotein (apo B-LP) and non-apo B-LP. The procedure requires the precipitation of apo B-LP, the redissolution of the pellet, and the quantification of C peptides in the redissolved pellet. The ratio of apo C in non-apo B...
journal_title：Clinical chemistry
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doi：
更新日期：1994-02-01 00:00:00
abstract：BACKGROUND:At concentrations <500 microg/L, serum alpha-fetoprotein (AFP) has low specificity in the diagnosis of hepatocellular carcinoma (HCC), but monosialylated AFP (msAFP) is more specific for HCC. We describe two strategies for quantitative analysis of msAFP and explore their diagnostic accuracy in cases of HCC w...
journal_title：Clinical chemistry
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doi：
更新日期：2002-07-01 00:00:00
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journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1980-04-01 00:00:00
abstract：:The method is based on the selective activating capacity of dithiothreitol on creatine kinase isoenzyme MB, after isoenzyme MM is activated by glutathione. Isolated isoenzymes MM and MB of human and canine origin were assayed individually and in mixtures of known activities. When glutathione was present in the assay m...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-10-01 00:00:00
abstract：:Solid-phase-based immunoassays have traditionally been plagued by nonspecific binding to the solid phase and by slow reaction kinetics relative to reactants that are free to diffuse in solution. We have developed two novel immunoassays in which the solid phase is generated in situ after the specific binding reaction h...
journal_title：Clinical chemistry
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doi：
更新日期：1987-09-01 00:00:00
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doi：10.1373/clinchem.2007.096032
更新日期：2008-04-01 00:00:00
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journal_title：Clinical chemistry
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doi：
更新日期：1994-07-01 00:00:00
abstract：:I describe the automation/mechanization of several areas of sample processing at SmithKline Beecham Clinical Laboratories. By analyzing and implementing new systems for conveyance and sorting of incoming specimens, specimen processing, within-laboratory specimen delivery, specimen storage and retrieval, and client res...
journal_title：Clinical chemistry
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doi：
更新日期：1990-09-01 00:00:00
abstract：BACKGROUND:Bilirubin has antioxidative and cytoprotective properties. Low plasma concentrations of bilirubin are reportedly associated with the development of coronary and cerebrovascular disease, and bilirubin concentrations are strongly correlated with the enzyme activity of the hepatic uridine diphosphate glucuronos...
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pub_type： 临床试验,杂志文章
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journal_title：Clinical chemistry
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doi：
更新日期：1985-10-01 00:00:00
abstract：:Proteinuria, long recognized as a sign of renal disease, is a common laboratory abnormality in children and adults. Proteinuria may be transient or persistent; when persistent, the cause must be determined. Proteinuria may be primarily glomerular or tubular in origin. Glomerular proteinuria is usually an important con...
journal_title：Clinical chemistry
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doi：
更新日期：1989-05-01 00:00:00
abstract：BACKGROUND:Little research has been done to examine whether gamma-glutamyltransferase (GGT) is prospectively associated with the development of chronic kidney disease (CKD). We performed a prospective study to examine the association between GGT and the risk for the development of CKD. METHODS:The study cohort include...
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doi：10.1373/clinchem.2006.078980
更新日期：2007-01-01 00:00:00
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journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：BACKGROUND:PCR-based mutation detection is prone to methodological errors, e.g., in restriction length fragment polymorphism (RFLP) and allele-specific amplification (ASA), false PCR results may occur because of technical faults or atypical new mutations. METHODS:We investigated the ability of a genotyping assay based...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1999-12-01 00:00:00
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journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1998-10-01 00:00:00
abstract：:The enzymatic determination of serum uric acid by use of uricase, catalase, and aldehyde dehydrogenase according to Haeckel [J. Clin. Chem. Clin Biochem. 14, 101 (1976)] showed interferences from ethanol-converting enzymes, which are present in some patients' sera. We have identified these enzymes as alcohol dehydroge...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1979-04-01 00:00:00
abstract：BACKGROUND:Measurement of postimmunization antibody response to pneumococcal capsular polysaccharide (caps-PS) is the standard method to identify deficiency of antipolysaccharide antibody production. However, no standardized criteria have been defined for classification of patients into responders or nonresponders to c...
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pub_type： 杂志文章
doi：10.1373/clinchem.2006.080051
更新日期：2007-03-01 00:00:00
abstract：:We modified a one-step, two-site, double monoclonal immunoenzymometric assay (Abbott Laboratories) for serum alpha1-fetoprotein (AFP) to increase its sensitivity and improve test precision at the low end. We increased sample size, incubation interval, and reaction time and temperature, and decreased the final reaction...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1987-04-01 00:00:00
abstract：BACKGROUND:Measurement of plasma renin is important for the clinical assessment of hypertensive patients. The most common methods for measuring plasma renin are the plasma renin activity (PRA) assay and the renin immunoassay. The clinical application of renin inhibitor therapy has thrown into focus the differences in i...
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pub_type： 杂志文章,评审
doi：10.1373/clinchem.2008.118000
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journal_title：Clinical chemistry
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doi：10.1373/clinchem.2009.140939
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journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:A new enzymic method is described for the determination of creatine in urine by continuous-flow analysis. The measurement is accomplished by transforming creatine to formaldehyde in reactions catalyzed by creatinase (creatine amidinohydrolase) and sarcosine dehydrogenase. The formaldehyde is reacted with 4-amino-3-hyd...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
abstract：:We adapted an inhibition assay for methotrexate, involving dihydrofolate reductase from bovine liver, for use with a discrete analyzer (the ABA-100). The analyzer was used both for dilution and a 5-min pre-incubation of the sample with NADPH--enzyme reagent, and for the assay itself. The standard curve was linear betw...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1980-02-01 00:00:00
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journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1996-04-01 00:00:00
abstract：:The most popular pretreatment method of plasma samples for the measurement of ascorbate (AsA) and dehydroascorbate (DHA) has been an acidic deproteinization via metaphosphoric acid or trichloroacetic acid. In general, DHA is absent in plasma samples prepared from human blood in a conventional manner. However, when the...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1998-04-01 00:00:00
abstract：BACKGROUND:D-2-Hydroxyglutaric aciduria (D-2-HGA), L-2-hydroxyglutaric aciduria (L-2-HGA), and the combined D/L-2-hydroxyglutaric aciduria (D/L-2-HGA) are poorly understood organic acidurias. To investigate the usefulness of cultured human skin fibroblasts for both diagnostic and research purposes, we measured disease-...
journal_title：Clinical chemistry
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doi：10.1373/49.7.1133
更新日期：2003-07-01 00:00:00
abstract：BACKGROUND:Concomitant quantification of multiple mutant KRAS (v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog) alleles may provide information in addition to that provided by standard mutation-detection procedures. We assessed the feasibility of a nanofluidic digital PCR array platform to detect and quantify KRAS...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2012.186577
更新日期：2012-09-01 00:00:00
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journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1998-12-01 00:00:00
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journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1984-03-01 00:00:00
abstract：BACKGROUND:The genotype of hepatitis C virus (HCV) is a predictor of antiviral therapeutic response. We describe an approach for HCV genotype determination by real-time PCR and melting curve analysis. METHODS:After automated nucleic acid extraction, we used reverse transcription-PCR in a block cycler to amplify nucleo...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：2002-12-01 00:00:00
