ACE2 and heart failure: In patients with atrial fibrillation, elevated plasma ACE2 activity was related to left atrial structural remodeling.[24] In patients with HF, increased plasma ACE2 levels independently predicted cardiovascular outcomes (hospitalization of heart failure, heart transplantation, or death) and were positively related to imaging indicators of ventricular remodeling as well as function disorder after 34 months of follow up.[31] Similarly, plasma ACE2 activity was associated with infarct size and more severe left ventricular remodeling after myocardial infarction with ST-segment elevation.[26]