INFLUENCE OF COMORBIDITIES ON BLOOD ALDOSTERONE LEVEL IN CHRONIC HEART FAILURE WITH PRESERVED SYSTOLIC FUNCTION OF THE LEFT VENTRICLE

Aim. To analyze relation of blood aldosterone level with comorbidities in patients with chronic heart failure (CHF) with preserved ejection fraction of the left ventricle (EF LV).

Material and methods. To the cross-sectional study, 158 patients included: 58 males, 100 females, mean age 62,3±7,4 y. o., with decompensated CHF with preserved EF LV (>50%) and diastolic dysfunction. Patients did not present with primary hyperaldosteronism and did not take mineralocorticoid antagonists within previous 6 weeks. All patients underwent blood specimens collection, and were assessed on the comorbid disorders and conditions. Reference values of the hormone were 40-160 pg/mL.

Results. According to the measurements, all patients were selected to two groups: I group included 99 (67,1%) of patients, who had normal hormone level; II — 59 (37,3%) patients with hyperaldosteronemia. Group II patients were younger — 57,75±7,5 y. o. vs 65,02±7,1 y. o. (p<0,001) and had more prominent presentation of the CHF (NYHA III) — 62,7% vs 33,3% cases (p<0,001) comparing to the group I. The prevalence of previus myocardial infarction was — 59,3% vs 41,4% (p=0,044), comorbid atrial fibrillation — 33,9% vs 17,2% (p=0,027), long-term (>10 years) arterial hypertension (AH) — 57,6% vs 25,3% (p<0,001), chronic obstructive lung disease (COLD) — 27,1% vs 7,1% (p=0,001), diabetes mellitus — 39,0% and 19,2% (p=0,011), obesity — 64,4% and 29,3% (p<0,001), and renal dysfunction — 88,1% and 50,5% (p<0,001) in the group II significantly higher than in group I. Multiple regression showed that after correction by age and severity of CHF, only long lasting AH, COLD, obesity and renal dysfunction were associated with hyperaldosteronemia.

Conclusion. In CHF with preserved EF LV patients, aldosterone level is closely linked with comorbidities. Long term anamnesis of AH, presence of COLD, obesity and renal dysfunction are independent factors for the risk of secondary hyperaldosteronism.

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