Relationship between transcardiac extraction of aldosterone and left ventricular remodeling in patients with first acute myocardial infarction: extracting aldosterone through the heart promotes ventricular remodeling after acute myocardial infarction

Autor: Toshiki Matsui, Takashi Yamamoto, Takayoshi Tsutamoto, Keiko Maeda, Takashi Tsutsui, Masahiko Kinoshita, Masato Ohnishi, Masanori Fujii, Takehiro Matsumoto, Hajime Horie, Atsuyuki Wada, Masaru Hayashi, Naoko Mabuchi
Rok vydání: 2001
Předmět:
Male
Time Factors
endocrine system diseases
Myocardial Infarction
Angiotensin-Converting Enzyme Inhibitors
Severity of Illness Index
chemistry.chemical_compound
Enalapril
Prospective Studies
Myocardial infarction
Angioplasty
Balloon
Coronary
Aldosterone
Aorta
Mineralocorticoid Receptor Antagonists
Ejection fraction
Ventricular Remodeling
Middle Aged
Coronary Vessels
Acute Disease
Disease Progression
Cardiology
Female
Cardiology and Cardiovascular Medicine
Procollagen
TIMI
medicine.drug
endocrine system
congenital
hereditary
and neonatal diseases and abnormalities
medicine.medical_specialty
Veins
Internal medicine
medicine
Cytochrome P-450 CYP11B2
Humans
cardiovascular diseases
Ventricular remodeling
Coronary sinus
Aged
Heart Failure
business.industry
nutritional and metabolic diseases
Stroke Volume
medicine.disease
Fibrosis
Peptide Fragments
chemistry
Heart failure
Multivariate Analysis
business
Biomarkers
Zdroj: Journal of the American College of Cardiology. 38:1375-1382
ISSN: 0735-1097
DOI: 10.1016/s0735-1097(01)01539-x
Popis: OBJECTIVESThe purpose of this study was to evaluate whether plasma aldosterone (ALD) is extracted or produced through the heart in patients with acute myocardial infarction (AMI) and to determine the relationship between transcardiac extraction of plasma ALD and left ventricular (LV) remodeling.BACKGROUNDAlthough we demonstrated that circulating ALD was extracted through the failing heart and that transcardiac extraction of ALD correlated with LV end-diastolic volume index (LVEDVI) in patients with congestive heart failure, the existence and increase of ALD synthase in the hearts of infarct rats were reported, suggesting cardiac production of ALD in patients with AMI.METHODSWe measured plasma ALD in the aortic root (Ao) and coronary sinus (CS) in 57 consecutive patients who received successful revascularization and enalapril, with first AMI at acute phase and after one month. We also measured plasma procollagen type III aminoterminal peptide (PIIINP) in the CS.RESULTSPlasma ALD was significantly lower in the CS than it was in the Ao at the acute phase (84.7 ± 6.3 pg/ml vs. 105.5 ± 8.0 pg/ml, p < 0.0001). Significant positive correlations exist between the transcardiac gradient of ALD at the acute phase and the LVEDVI at one month. Moreover, the transcardiac gradient of plasma ALD at the acute phase has a significant correlation with plasma PIIINP, a biochemical marker of fibrosis, after one month. Stepwise multivariate analysis showed that transcardiac extraction of plasma ALD at the acute phase had an independent and significant positive relationship with a large LVEDVI after one month.CONCLUSIONSThese results indicate that plasma ALD is extracted through the heart in patients with AMI at the acute phase and that the extracted ALD plays an important role in modulating post-infarct LV remodeling.
Databáze: OpenAIRE
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