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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/25006

Title: Plasma renin activity in patients with heart failure and reduced ejection fraction on optimal medical therapy
Authors: Nijst, Petra
Verbrugge, Frederik H.
Martens, Pieter
Bertrand, Philippe B.
Dupont, Matthias
Francis, Gary S.
Tang, W. H. Wilson
Mullens, Wilfried
Issue Date: 2017
Citation: JOURNAL OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM, 18(3), p. 1-9 (Art N° 1470320317729919)
Abstract: Background: Renin-angiotensin-aldosterone system (RAAS) activation in heart failure with reduced ejection fraction (HFREF) is detrimental through promotion of ventricular remodeling and salt and water retention. Aims: The aims of this article are to describe RAAS activity in distinct HFREF populations and to assess its prognostic impact. Methods: Venous blood samples were prospectively obtained in 76 healthy volunteers, 72 patients hospitalized for acute decompensated HFREF, and 78 ambulatory chronic HFREF patients without clinical signs of congestion. Sequential measurements were performed in patients with acute decompensated HFREF. Results: Plasma renin activity (PRA) was significantly higher in ambulatory chronic HFREF (7.6ng/ml/h (2.2; 18.1)) compared to patients with acute decompensated HFREF (1.5 ng/ml/h (0.8; 5.7)) or healthy volunteers (1.4 ng/ml/h (0.6; 2.3)) (all p < 0.05). PRA was significantly associated with arterial blood pressure and renin-angiotensin system blocker dose. A progressive rise in PRA (+4 ng/ml/h (0.4; 10.9); p < 0.001) was observed in acute decompensated HFREF patients after three consecutive days of decongestive treatment. Only in acute HFREF were PRA levels associated with increased cardiovascular mortality or HF readmissions (p = 0.035). Conclusion: PRA is significantly elevated in ambulatory chronic HFREF patients but is not associated with worse outcome. In contrast, in acute HFREF patients, PRA is associated with cardiovascular mortality or HF readmissions.
Notes: [Nijst, Petra; Verbrugge, Frederik H.; Martens, Pieter; Bertrand, Philippe B.; Dupont, Matthias; Mullens, Wilfried] Ziekenhuis Oost Limburg, Dept Cardiol, Schiepse Bos 6, B-3600 Genk, Belgium. [Nijst, Petra; Martens, Pieter; Bertrand, Philippe B.] Hasselt Univ, Doctoral Sch Med & Life Sci, Hasselt, Belgium. [Francis, Gary S.] Univ Minnesota Hlth Heart Care, Cardiovac Div, Minneapolis, MN USA. [Tang, W. H. Wilson] Inst Heart & Vasc, Dept Cardiovas Med, Cleveland, OH USA. [Mullens, Wilfried] Hasselt Univ, Fac Med & Life Sci, Biomed Res Inst, Hasselt, Belgium.
URI: http://hdl.handle.net/1942/25006
DOI: 10.1177/1470320317729919
ISI #: 000410101400001
ISSN: 1470-3203
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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