my personal edition > congestive heart failure > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Aldosterone Levels Higher in Patients With Heart Failure: Presented at ESC(CARD)

By Ed Susman

VIENNA, AUSTRIA -- September 2, 2003 -- Aldosterone levels are increased in patients with heart failure, according to an analysis of the Valsartan Heart Failure Trial (Val-HeFT), reported here August 31^st during the European Society of Cardiology Congress 2003.

"Patients with heart failure have increased levels of plasma aldosterone and higher levels are seen in patients with more advanced heart failure," said Inder Anand, MD, professor of medicine, University of Minnesota, Minneapolis.

The researchers did not find that levels of aldosterone are, by themselves, an independent predictor of mortality. On the other hand, Dr. Anand said that levels of the hormone could be an adjunct predictor of morbidity in the presence of heart failure.

For the Val-HeFT study, researchers determined plasma aldosterone levels at baseline and during follow-up through radioimmunoassay in core labs. The median baseline level of 104.1 pg/mL was used to separate the patients into two cohorts for study according to median plasma aldosterone value: 2,025 patients had high levels and 2,023 had low levels. A total of 5,010 patients were enrolled in Val-HeFT.

When the researchers analyzed the differences based on higher or lower values, they found that 43.3% of patients with higher levels had heart failure that was classified as York Heart Association Class III or IV, compared with 32.75% of patients with lower values (P<.001).

The patients with higher aldosterone levels also had lower blood pressure levels and lower left-ventricular ejection fractions, but higher heart rates. They also had higher mean plasma values of norepinephrine.

Although there appeared to be differences in mortality on the basis of aldosterone levels, Dr. Anand said that when multivariate analyses were performed those differences lost their significance.

The level of aldosterone did correlate, however, with the first morbid event experienced; this patient was among those with a higher aldosterone level. After about 3 years, approximately 30% of the patients with low aldosterone levels had experienced a morbid event compared with about 45% of those who had higher levels (P=.02441).

"Although aldosterone has been shown to be important in the progression of heart failure through its effects in the mineralocorticoid receptor, and aldosterone receptor blockade has beneficial effects in heart failure, the circulating level of the hormone may not be an important independent predictor of mortality," Dr. Anand concluded.


[Study title: Prognostic value of aldosterone in heart failure. Results from Val-HeFT European Heart Journal Vol 24, Abstr. Suppl. August/September 2003, page 60. Abstract P433]

E-Mail this DGDispatch to a colleague

To print, use this version