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(Hypertension. 1999;33:1374-1378.)
© 1999 American Heart Association, Inc.

Scientific Contributions

Angiotensin-Converting Enzyme Inhibition Restores Hepatocyte Growth Factor Production in Patients With Congestive Heart Failure

Satoshi Yasuda; Yoichi Goto; Hitoshi Sumida; Teruo Noguchi; Takeshi Baba; Shunichi Miyazaki; Hiroshi Nonogi

From the Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Osaka, Japan.

Correspondence to Satoshi Yasuda, MD, Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan. E-mail syasuda{at}hsp.ncvc.go.jp

Abstract—Endothelium-dependent vasodilation is impaired in patients with congestive heart failure. For vascular endothelium, hepatocyte growth factor (HGF) is one of the most potent and specific growth factors, which acts protectively against endothelial dysfunction. HGF production is downregulated by angiotensin II (Ang II) in vitro. We hypothesized that HGF production is impaired as the result of increased Ang II in patients with congestive heart failure, and that if so, the impaired production should be restored with angiotensin-converting enzyme inhibitors (ACE-I). We studied 16 patients with congestive heart failure caused by previous anterior myocardial infarction in whom left ventricular ejection fraction was 35±8% (mean±SD). Before and 4 weeks after the treatment with ACE-I, blood samples were collected to measure the levels of HGF, Ang II, and brain natriuretic peptide as a biochemical marker for severity of heart failure. We also studied 5 control subjects, in whom heparin increased HGF production to 48±5-fold. However, in patients with heart failure, HGF response to heparin was significantly attenuated (24±5-fold, P<0.05 vs control). Therapy with ACE-I decreased the levels of Ang II and brain natriuretic peptide and restored HGF production in response to heparin by 43±7-fold, comparable to the control response. In conclusion, impaired HGF production was restored after the treatment with ACE-I probably by the mechanism of Ang II suppression. This novel effect of ACE-I may contribute to the clinical improvement in patients with heart failure and thereby may have an important therapeutic implication.

Key Words: angiotensin • endothelium • growth factors • heart failure • natriuretic peptides

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