Interrelation between plasma levels of aldosterone and brain natriuretic peptide in chronic heart failure with preserved ejection fraction

Purpose. The study aims to investigate the interrelation between plasma levels of aldosterone and brain natriuretic peptide in heart failure with preserved ejection fraction (HFpEF).

Material and methods. A cross-sectional study included 158 patients with HFpEF. The diagnosis of HFpEF was made in the presence of symptoms and/or signs of heart failure, left ventricular EF 50%, increased NT-proBNP level and structural changes in the heart within echocardiography. The study did not include patients with primary hyperaldosteronism and those who received mineralocorticoid receptors antagonists in the previous 6 weeks. In all patients plasma levels of aldosterone and NT-proBNP were evaluated.

Results. Patients’ mean age was 69.9 ± 6.35 years; most of them were women (64%). According to laboratory results 99 patients (63%) had normal (40–160 pg/ml) aldosterone plasma level (nAld) and 59 patients (37%) had high (160 pg/ml) aldosterone level (hAld). hAld patients were younger and, most likely, had comorbidity. They had higher level of NT-proBNP compared to nAld (median level 480 (356–623) pg/ml versus 224 (165–302) pg/ml, p < 0.001). Body mass index, systolic blood pressure, total cholesterol, low density lipoproteins, creatinine and E/e’ were signifi cantly higher in hAld group, while plasma potassium and glomerular fi ltration rate were lower compared to nAld group (р < 0.05). Plasma aldosterone was strongly and positively correlated with NT-proBNP (r = 0.593, p < 0.001).

Conclusion. In HFpEF plasma aldosterone is closely related to NT-proBNP. The level of NT-proBNP is signifi cantly higher in patietns with hyperaldosteronemia compared to patients with normal aldosterone.

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