Взаимосвязь плазменных уровней альдостерона и липидов у пациентов с хронической сердечной недостаточностью с сохраненной фракцией выброса

Abstract

The purpose — to determine the relationship between aldosterone plasma level and lipid blood profile in patients with heart failure with preserved ejection fraction (HFpEF). Material and methods. A cross-sectional study was carried out with 158 patients with stable HFpEF. Aldosterone plasma level was measured by immunoenzyme method with the reference value of 40–160 pg/ml. The assay of lipid blood profile included measurement of total cholesterol (TC), low (LDL-C) and high density (HDL-C) lipoprotein cholesterol and triglycerides (TG). Results. According to laboratory results, 99 patients (62,7%, 95% confidence interval (CI) 55–70%) had normal (40–160 pg/ml) aldosterone plasma level (nAld) and 59 patients (37,3%, 95% CI 30–45%) had high (>160 pg/ml) aldosterone level (hAld). Levels of TC, LDL-C and TG in hAld group were significantly higher compared to nAld (p < 0,001). Correlation analysis showed significant (all Ps < 0,001) positive correlation between aldosterone and TC (r = 0,66), LDL cholesterol (r = 0,59), TG (r = 0,74) and body mass index (r = 0,59). Aldosterone did not correlate with HDL-C. Hyperaldosteronemia was a significant risk factor of high TC (odds ratio (OR) 4,44, 95% CI 1,97–10, for TC > 5 mmol/L, p < 0,001), LDL-C (OR 3,35, 95% CI 1,56 –7,21, for LDL-C > 3 mmol/L, p = 0,001) and TG (OR 3,04, 95% CI 1,43–6,90 for TG > 1,7 mmol/L, p = 0,006). TC, LDL-C and TG were significantly higher in obesity than in normal or overweight (p < 0,05). Significant changes in HDL-C depending on body mass index were not detected. Conclusions. In patients with HFpEF, aldosterone plasma level is closely related to TC, LDL-C and TG. Among hyperaldosteronic patients dyslipidemia is most severe in case of obesity.