Renin Feedback Is an Independent Predictor of Outcome in HFpEF
| Autor: | Marko Poglitsch, Christian Hengstenberg, Christina Binder, Luciana Camuz Ligios, Hong Qin, Benjamin Seirer, Lore Schrutka, Theresa Marie Dachs, C Capelle, Daniel Dalos, René Rettl, Franz Duca, Diana Bonderman, Roza Badr Eslam |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Medicine (miscellaneous) heart failure 030204 cardiovascular system & hematology Independent predictor Plasma renin activity Article 03 medical and health sciences 0302 clinical medicine RAAS Internal medicine Renin–angiotensin system medicine Clinical endpoint 030212 general & internal medicine Ejection fraction business.industry Confounding Hazard ratio angiotensin medicine.disease renin Heart failure Cardiology outcome Medicine business |
| Zdroj: | Journal of Personalized Medicine Volume 11 Issue 5 Journal of Personalized Medicine, Vol 11, Iss 370, p 370 (2021) |
| ISSN: | 2075-4426 |
| DOI: | 10.3390/jpm11050370 |
| Popis: | Drugs which interact with the renin angiotensin aldosterone system (RAAS) aim to reduce the negative effects of angiotensin (Ang) II. Treatment with these drugs anticipate a compensatory up-regulation of renin however, it has been shown that there is a large variability in circulating plasma renin (PRA), even in patients with optimal medical therapy in patients with heart failure (HF) with reduced ejection fraction (HFrEF). Our aim was to measure plasma renin activity (PRA-S), its response to RAAS inhibitor (RAASi) therapies and its effects on outcome in patients with HF with preserved ejection fraction (HFpEF). For this purpose, 150 HFpEF patients were included into a prospective single-center registry. Equilibrium (eq) angiotensin metabolites were measured from serum samples using mass spectroscopy. PRA-S (eqAng I + eqAng II) was calculated and compared in respect to the primary endpoint defined as all-cause death. PRA-S in patients with RAASi therapy was not significantly higher than in patients without RAASi (p = 0.262). Even after adjusting for confounding factors, PRA-S remained predictive for all-cause death in the multivariable model with a hazard ratio of 2.14 (95%CI 1.20–3.82, p = 0.010). We conclude that high PRA-S is associated with poor prognosis in patients with HFpEF, regardless of RAASi treatment, which could ultimately result in hyperactivated RAAS and consecutive negative effects on the cardiovascular and renal system, leading to poor outcome in patients with HFpEF. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|