Portal de investigação
Role of aldosterone in mid- and long-term left ventricular remodelling after acute myocardial infarction: The REMI study
Data de publicação:
Autores da FMUP
Participantes de fora da FMUP
- Monzo L.
- Huttin O.
- Lamiral Z.
- Bozec E.
- Beaumont M.
- Micard E.
- Baudry G.
- Marie P.-Y.
- Eschalier R.
- Rossignol P.
- Zannad F.
- Girerd N.
Unidades de investigação
Abstract
Aims: Whether aldosterone levels after myocardial infarction (MI) are associated with mid- and long-term left ventricular (LV) remodelling in the era of systematic use of renin–angiotensin system inhibitors is uncertain. We prospectively investigated the relationship between aldosterone levels and mid- and long-term LV remodelling in patients with acute MI. Methods and results: Plasma aldosterone was measured in 119 patients successfully treated by primary percutaneous coronary angioplasty for a first acute ST-elevation MI (STEMI) 2–4 days after the acute event. LV volumes were assessed by cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE) in the same timeframe and 6 months later. LV assessment was repeated by TTE 3–9 years after MI (n = 80). The median aldosterone level at baseline was 23.1 [16.8; 33.1] pg/ml. In the multivariable model, higher post-MI aldosterone concentration was significantly associated with more pronounced increase in LV end-diastolic volume index (TTE: ß ± standard error [SE]: 0.113 ± 0.046, p = 0.015; CMR: ß ± SE: 0.098 ± 0.040, p = 0.015) and LV end-systolic volume index (TTE: ß ± SE: 0.083 ± 0.030, p = 0.008; CMR: ß ± SE: 0.064 ± 0.032, p = 0.048) at 6-month follow-up, regardless of the method of assessment. This result was consistent also in patients with a LV ejection fraction (LVEF) >40%. The association between baseline plasma aldosterone and adverse LV remodelling did not persist at the 3–9-year follow-up evaluation. Conclusion: Aldosterone concentration in the acute phase was associated with adverse LV remodelling in the medium term, even in the subgroup of patients with LVEF >40%, suggesting a potential role of the mineralocorticoid system in post-MI adverse remodelling. Plasma aldosterone was no longer associated with LV remodelling in the long term (NCT01109225). © 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
Dados da publicação
- ISSN/ISSNe:
- 1388-9842, 1879-0844
- Tipo:
- Article
- Páginas:
- 1742-1752
- DOI:
- 10.1002/ejhf.2986
- Link para outro recurso:
- www.scopus.com
European Journal of Heart Failure Wiley-Blackwell
Citações Recebidas na Scopus: 6
Documentos
- Não há documentos
Filiações
Keywords
- Aldosterone; Heart Failure; Humans; Myocardial Infarction; ST Elevation Myocardial Infarction; Stroke Volume; Ventricular Function, Left; Ventricular Remodeling; aldosterone; aldosterone; acute heart infarction; adult; aldosterone blood level; Article; cardiovascular magnetic resonance; cardiovascular parameters; clinical feature; clinical trial; female; follow up; heart left ventricle ejection fraction; heart left ventricle enddiastolic volume; heart left ventricle endsystolic volume; heart ventricle volume; human; left ventricular remodelling; major clinical study; male; middle aged; prospective study; risk factor; ST segment elevation myocardial infarction; transluminal coronary angioplasty; transthoracic echocardiography; complication; heart failure; heart infarction; heart left ventricle function; heart stroke volume; heart ventricle remodeling; ST segment elevation myocardial infarction
Financiamento
Proyectos asociados
Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022
Citar a publicação
Monzo L,Huttin O,Ferreira JP,Lamiral Z,Bozec E,Beaumont M,Micard E,Baudry G,Marie P-Y,Eschalier R,Rossignol P,Zannad F,Girerd N. Role of aldosterone in mid- and long-term left ventricular remodelling after acute myocardial infarction: The REMI study. Eur. J. Heart Fail. 2023. 25. (10):p. 1742-1752. IF:18,200. (1).
