Elevated plasma soluble (pro)renin receptor levels are associated with left ventricular remodeling and renal function in chronic heart failure patients with reduced ejection fraction

Soluble (pro)renin receptor [s(P)RR], which is generated from cleavage of (P)RR, can be detected in plasma and urine. s(P)RR levels can reflect the severity of some diseases, such as renal lesions, gestational diabetes mellitus or hypertension, and obstructive sleep apnea syndrome. However, the relationship between s(P)RR levels and the severity of chronic heart failure remains undetermined. We studied s(P)RR levels in 118 patients with chronic heart failure with reduced ejection fraction (HFrEF), including 86 without renal dysfunction (HF) and 32 with renal dysfunction (HF + RF), and 28 healthy subjects (HS) to reveal the relationship between s(P)RR levels and other HFrEF parameters. Plasma s(P)RR levels were 22.2 +/- 4.1 ng/mL (HS), 26.4 +/- 5.3 ng/mL (HF) and 30.0 +/- 5.3 ng/mL (HF + RF). Plasma s(P)RR levels were significantly higher in the HF group than in the HS group (P < 0.001) and even more increased in the HF + RF group (P < 0.001 vs. the HS group and P < 0.05 vs. the HF group). Multivariate regression analysis revealed that the left ventricular mass index (LVMI) and estimated glomerular filtration rate (eGFR) were independently related to s(P)RR levels in HFrEF patients. In conclusion, high plasma s(P)RR levels are associated with left ventricular remodeling and, especially, with renal dysfunction. Therefore, s(P)RR is a promising evaluative indicator for the severity of HFrEF patients.