2016


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2016/№3

The role of hyperaldosteronemia in recurrent atrial fibrillation

Vatutin N. T.1, Shevelyok A. N.1, Kravchenko I. N.2
1 – “M. Gorky Donetsk National Medical University” of the Ukraine Ministry of Health Care, Prospekt Iljicha 16, Donetsk 83003, Ukraine
2 – State Institution, “V. K. Gusak Institute of Urgent and Reconstructive Surgery of the Ukrainian National Academy of Medical Sciences”, Leninskij Prospekt 47, Donetsk 83045, Ukraine

Keywords: aldosterone, hyperaldosteronism, relapses of atrial fibrillation, prognosis, risk

DOI: 10.18087/rhj.2016.3.2128

Background. Hyperactivation of the RAAS plays a key role in structural remodeling of the myocardium, which underlies atrial fibrillation (AF). However, the role of excessive aldosterone production in AF relapses is unknown. Aim. To analyze changes in the level of blood aldosterone during AF attacks and after recovery of the sinus rhythm. Materials and methods. The study included 46 patients (24 males and 12 females, mean age 59.6±6.2) with recurrent nonvalvular AF. Serum aldosterone was measured using the immunoenzyme method twice, during an AF attack and at 24–48 h of heart rhythm (HR) recovery. After that patients were followed up for 3 months, and AF relapses were recorded. Results. 14 (30 %) patients had AF relapses (group 1); the remaining 32 (70 %) preserved the HR (group 2). The initial level of plasma aldosterone measured during an arrhythmia attack did not significantly differ between groups 1 and 2 (312.4±19.4 and 286.3±22.6 pg / ml, respectively (р=0.072). After successful cardioversion, the hormone concentration significantly decreased only in group 2 (to 184.2±13.6 pg / ml; р<0.001) whereas in group 1, the decrease did not reach a statistical significance (289.4±18.4 pg / ml; р=0.07). The absence of 25 % decrease in aldosterone level within 24 h of HR recovery was a predictor for recurrent arrhythmia (OR, 2.42; 95 % CI, 1.86–4.06, р=0.01). Conclusion. In patients with recurrent AF, blood concentration of aldosterone increased during arrhythmia and decreased at 24–48 h of HR recovery. The absence of 25 % decrease in aldosterone following successful cardioversion was a predictor for recurrent arrhythmia in the next 3 months.
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Vatutin N. T., Shevelyok A. N., Kravchenko I. N. The role of hyperaldosteronemia in recurrent atrial fibrillation. Russian Heart Journal. 2016;15 (3):161–165

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