The predictability of renin–angiotensin–aldosterone system factors for clinical outcome in patients with acute decompensated heart failure
Although counter-regulation between B-type natriuretic peptide (BNP) levels and renin–angiotensin–aldosterone system (RAAS) activation in heart failure (HF) has been suggested, whether the regulation is preserved in acute decompensated heart failure (ADHF) patients remains unclear. This study aimed...
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| Veröffentlicht in: | Heart and vessels 2016-06, Vol.31 (6), p.925-931 |
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| creator | Nakada, Yasuki Takahama, Hiroyuki Kanzaki, Hideaki Sugano, Yasuo Hasegawa, Takuya Ohara, Takahiro Amaki, Makoto Funada, Akira Yoshida, Akemi Yasuda, Satoshi Ogawa, Hisao Anzai, Toshihisa |
| description | Although counter-regulation between B-type natriuretic peptide (BNP) levels and renin–angiotensin–aldosterone system (RAAS) activation in heart failure (HF) has been suggested, whether the regulation is preserved in acute decompensated heart failure (ADHF) patients remains unclear. This study aimed to determine: (1) the relationship between RAAS activation and clinical outcomes in ADHF patients, and (2) the relationships between plasma BNP levels and degrees of activation in RAAS factors. This study included ADHF patients (
n
= 103, NYHA3-4, plasma BNP > 200 pg/ml). We studied the predictability of RAAS factors for cardiovascular events and the relationships between plasma BNP levels and the degrees of activation in RAAS factors, which were evaluated by plasma renin activity (PRA) and aldosterone concentration (PAC). PRA was a strong predictor of cardiovascular (CV) events over 1 year, even after accounting for plasma BNP levels (hazard ratio (HR): 1.04, CI [1.02–1.06],
p
|
| doi_str_mv | 10.1007/s00380-015-0688-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1808612093</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1793908849</sourcerecordid><originalsourceid>FETCH-LOGICAL-c429t-a7feb6e4913f3ba3d4a8b0b8a1c88d7516bae2acee2d3008495431e196fe01f53</originalsourceid><addsrcrecordid>eNqFkc1u1TAQRi0Eope2D8AGWWLDJnQcJ7G9RBV_UiU2ZW05zqTXVWIH2xG6uz4BG96QJ8GXFISQUFf2aM6c0egj5DmD1wxAXCQALqEC1lbQSVmJR2THulLVreCPyQ4Ug0ryWpyQZyndQgEVU0_JSd2qrgHBd-Tb9R7pEnFwNpveTS4faBhpRO_8j7vvxt-4kNGnrZqGkDLG4JGmQ_nNdDQ2h5joGCK1k_POmomGNdswI3WeLiY79DnRry7vqbFrRjpg6S5FajIOdI8m5uJx0xrxjDwZzZTw_P49JZ_fvb2-_FBdfXr_8fLNVWWbWuXKiBH7DhvF-Mh7w4fGyB56aZiVchAt63qDtbGI9cABZKPahjNkqhsR2NjyU_Jq8y4xfFkxZT27ZHGajMewJs0kyI7VoPjDqFBcgSw7CvryH_Q2rNGXQ35RnQRRi0KxjbIxpBRx1Et0s4kHzUAfc9VbrrrEpY-56uPMi3vz2s84_Jn4HWQB6g1IpeVvMP61-r_Wn0r3sqw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1793680727</pqid></control><display><type>article</type><title>The predictability of renin–angiotensin–aldosterone system factors for clinical outcome in patients with acute decompensated heart failure</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Nakada, Yasuki ; Takahama, Hiroyuki ; Kanzaki, Hideaki ; Sugano, Yasuo ; Hasegawa, Takuya ; Ohara, Takahiro ; Amaki, Makoto ; Funada, Akira ; Yoshida, Akemi ; Yasuda, Satoshi ; Ogawa, Hisao ; Anzai, Toshihisa</creator><creatorcontrib>Nakada, Yasuki ; Takahama, Hiroyuki ; Kanzaki, Hideaki ; Sugano, Yasuo ; Hasegawa, Takuya ; Ohara, Takahiro ; Amaki, Makoto ; Funada, Akira ; Yoshida, Akemi ; Yasuda, Satoshi ; Ogawa, Hisao ; Anzai, Toshihisa</creatorcontrib><description>Although counter-regulation between B-type natriuretic peptide (BNP) levels and renin–angiotensin–aldosterone system (RAAS) activation in heart failure (HF) has been suggested, whether the regulation is preserved in acute decompensated heart failure (ADHF) patients remains unclear. This study aimed to determine: (1) the relationship between RAAS activation and clinical outcomes in ADHF patients, and (2) the relationships between plasma BNP levels and degrees of activation in RAAS factors. This study included ADHF patients (
n
= 103, NYHA3-4, plasma BNP > 200 pg/ml). We studied the predictability of RAAS factors for cardiovascular events and the relationships between plasma BNP levels and the degrees of activation in RAAS factors, which were evaluated by plasma renin activity (PRA) and aldosterone concentration (PAC). PRA was a strong predictor of cardiovascular (CV) events over 1 year, even after accounting for plasma BNP levels (hazard ratio (HR): 1.04, CI [1.02–1.06],
p
< 0.01) and medication such as RAAS blockers (HR: 1.03, CI [1.01–1.05],
p
< 0.01), whereas PAC was borderline-significant (univariate analysis,
p
= 0.06). Cut-off value of PRA (5.3 ng/ml/h) was determined by AUC curve. Of the enrolled patients, higher PRA was found in 40 % of them. Although no correlation between the plasma BNP levels and PRA was found (
p
= 0.36), after adjusting for hemodynamic parameters, eGFR and medication, a correlation was found between them (
p
= 0.01). Elevated RAAS factors were found in a substantial number of ADHF patients with high plasma BNP levels in the association with hemodynamic state, which predicts poor clinical outcomes. The measurements of RAAS factors help to stratify ADHF patients at risk for further CV events.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-015-0688-7</identifier><identifier>PMID: 25964073</identifier><identifier>CODEN: HEVEEO</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Acute Disease ; Aged ; Aged, 80 and over ; Aldosterone - blood ; Area Under Curve ; Biomarkers - blood ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Clinical outcomes ; Female ; Heart failure ; Heart Failure - blood ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Heart Failure - therapy ; Hemodynamics ; Humans ; Japan ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Original Article ; Peptides ; Predictive Value of Tests ; Renin - blood ; Renin-Angiotensin System ; Retrospective Studies ; ROC Curve ; Studies ; Treatment Outcome ; Up-Regulation ; Vascular Surgery</subject><ispartof>Heart and vessels, 2016-06, Vol.31 (6), p.925-931</ispartof><rights>Springer Japan 2015</rights><rights>Springer Japan 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c429t-a7feb6e4913f3ba3d4a8b0b8a1c88d7516bae2acee2d3008495431e196fe01f53</citedby><cites>FETCH-LOGICAL-c429t-a7feb6e4913f3ba3d4a8b0b8a1c88d7516bae2acee2d3008495431e196fe01f53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-015-0688-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-015-0688-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25964073$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakada, Yasuki</creatorcontrib><creatorcontrib>Takahama, Hiroyuki</creatorcontrib><creatorcontrib>Kanzaki, Hideaki</creatorcontrib><creatorcontrib>Sugano, Yasuo</creatorcontrib><creatorcontrib>Hasegawa, Takuya</creatorcontrib><creatorcontrib>Ohara, Takahiro</creatorcontrib><creatorcontrib>Amaki, Makoto</creatorcontrib><creatorcontrib>Funada, Akira</creatorcontrib><creatorcontrib>Yoshida, Akemi</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Anzai, Toshihisa</creatorcontrib><title>The predictability of renin–angiotensin–aldosterone system factors for clinical outcome in patients with acute decompensated heart failure</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Although counter-regulation between B-type natriuretic peptide (BNP) levels and renin–angiotensin–aldosterone system (RAAS) activation in heart failure (HF) has been suggested, whether the regulation is preserved in acute decompensated heart failure (ADHF) patients remains unclear. This study aimed to determine: (1) the relationship between RAAS activation and clinical outcomes in ADHF patients, and (2) the relationships between plasma BNP levels and degrees of activation in RAAS factors. This study included ADHF patients (
n
= 103, NYHA3-4, plasma BNP > 200 pg/ml). We studied the predictability of RAAS factors for cardiovascular events and the relationships between plasma BNP levels and the degrees of activation in RAAS factors, which were evaluated by plasma renin activity (PRA) and aldosterone concentration (PAC). PRA was a strong predictor of cardiovascular (CV) events over 1 year, even after accounting for plasma BNP levels (hazard ratio (HR): 1.04, CI [1.02–1.06],
p
< 0.01) and medication such as RAAS blockers (HR: 1.03, CI [1.01–1.05],
p
< 0.01), whereas PAC was borderline-significant (univariate analysis,
p
= 0.06). Cut-off value of PRA (5.3 ng/ml/h) was determined by AUC curve. Of the enrolled patients, higher PRA was found in 40 % of them. Although no correlation between the plasma BNP levels and PRA was found (
p
= 0.36), after adjusting for hemodynamic parameters, eGFR and medication, a correlation was found between them (
p
= 0.01). Elevated RAAS factors were found in a substantial number of ADHF patients with high plasma BNP levels in the association with hemodynamic state, which predicts poor clinical outcomes. The measurements of RAAS factors help to stratify ADHF patients at risk for further CV events.</description><subject>Acute Disease</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aldosterone - blood</subject><subject>Area Under Curve</subject><subject>Biomarkers - blood</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Clinical outcomes</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Japan</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Original Article</subject><subject>Peptides</subject><subject>Predictive Value of Tests</subject><subject>Renin - blood</subject><subject>Renin-Angiotensin System</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Studies</subject><subject>Treatment Outcome</subject><subject>Up-Regulation</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc1u1TAQRi0Eope2D8AGWWLDJnQcJ7G9RBV_UiU2ZW05zqTXVWIH2xG6uz4BG96QJ8GXFISQUFf2aM6c0egj5DmD1wxAXCQALqEC1lbQSVmJR2THulLVreCPyQ4Ug0ryWpyQZyndQgEVU0_JSd2qrgHBd-Tb9R7pEnFwNpveTS4faBhpRO_8j7vvxt-4kNGnrZqGkDLG4JGmQ_nNdDQ2h5joGCK1k_POmomGNdswI3WeLiY79DnRry7vqbFrRjpg6S5FajIOdI8m5uJx0xrxjDwZzZTw_P49JZ_fvb2-_FBdfXr_8fLNVWWbWuXKiBH7DhvF-Mh7w4fGyB56aZiVchAt63qDtbGI9cABZKPahjNkqhsR2NjyU_Jq8y4xfFkxZT27ZHGajMewJs0kyI7VoPjDqFBcgSw7CvryH_Q2rNGXQ35RnQRRi0KxjbIxpBRx1Et0s4kHzUAfc9VbrrrEpY-56uPMi3vz2s84_Jn4HWQB6g1IpeVvMP61-r_Wn0r3sqw</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Nakada, Yasuki</creator><creator>Takahama, Hiroyuki</creator><creator>Kanzaki, Hideaki</creator><creator>Sugano, Yasuo</creator><creator>Hasegawa, Takuya</creator><creator>Ohara, Takahiro</creator><creator>Amaki, Makoto</creator><creator>Funada, Akira</creator><creator>Yoshida, Akemi</creator><creator>Yasuda, Satoshi</creator><creator>Ogawa, Hisao</creator><creator>Anzai, Toshihisa</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160601</creationdate><title>The predictability of renin–angiotensin–aldosterone system factors for clinical outcome in patients with acute decompensated heart failure</title><author>Nakada, Yasuki ; Takahama, Hiroyuki ; Kanzaki, Hideaki ; Sugano, Yasuo ; Hasegawa, Takuya ; Ohara, Takahiro ; Amaki, Makoto ; Funada, Akira ; Yoshida, Akemi ; Yasuda, Satoshi ; Ogawa, Hisao ; Anzai, Toshihisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c429t-a7feb6e4913f3ba3d4a8b0b8a1c88d7516bae2acee2d3008495431e196fe01f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Acute Disease</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aldosterone - blood</topic><topic>Area Under Curve</topic><topic>Biomarkers - blood</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Clinical outcomes</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Japan</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Original Article</topic><topic>Peptides</topic><topic>Predictive Value of Tests</topic><topic>Renin - blood</topic><topic>Renin-Angiotensin System</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Studies</topic><topic>Treatment Outcome</topic><topic>Up-Regulation</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakada, Yasuki</creatorcontrib><creatorcontrib>Takahama, Hiroyuki</creatorcontrib><creatorcontrib>Kanzaki, Hideaki</creatorcontrib><creatorcontrib>Sugano, Yasuo</creatorcontrib><creatorcontrib>Hasegawa, Takuya</creatorcontrib><creatorcontrib>Ohara, Takahiro</creatorcontrib><creatorcontrib>Amaki, Makoto</creatorcontrib><creatorcontrib>Funada, Akira</creatorcontrib><creatorcontrib>Yoshida, Akemi</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Anzai, Toshihisa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakada, Yasuki</au><au>Takahama, Hiroyuki</au><au>Kanzaki, Hideaki</au><au>Sugano, Yasuo</au><au>Hasegawa, Takuya</au><au>Ohara, Takahiro</au><au>Amaki, Makoto</au><au>Funada, Akira</au><au>Yoshida, Akemi</au><au>Yasuda, Satoshi</au><au>Ogawa, Hisao</au><au>Anzai, Toshihisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The predictability of renin–angiotensin–aldosterone system factors for clinical outcome in patients with acute decompensated heart failure</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>31</volume><issue>6</issue><spage>925</spage><epage>931</epage><pages>925-931</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><coden>HEVEEO</coden><abstract>Although counter-regulation between B-type natriuretic peptide (BNP) levels and renin–angiotensin–aldosterone system (RAAS) activation in heart failure (HF) has been suggested, whether the regulation is preserved in acute decompensated heart failure (ADHF) patients remains unclear. This study aimed to determine: (1) the relationship between RAAS activation and clinical outcomes in ADHF patients, and (2) the relationships between plasma BNP levels and degrees of activation in RAAS factors. This study included ADHF patients (
n
= 103, NYHA3-4, plasma BNP > 200 pg/ml). We studied the predictability of RAAS factors for cardiovascular events and the relationships between plasma BNP levels and the degrees of activation in RAAS factors, which were evaluated by plasma renin activity (PRA) and aldosterone concentration (PAC). PRA was a strong predictor of cardiovascular (CV) events over 1 year, even after accounting for plasma BNP levels (hazard ratio (HR): 1.04, CI [1.02–1.06],
p
< 0.01) and medication such as RAAS blockers (HR: 1.03, CI [1.01–1.05],
p
< 0.01), whereas PAC was borderline-significant (univariate analysis,
p
= 0.06). Cut-off value of PRA (5.3 ng/ml/h) was determined by AUC curve. Of the enrolled patients, higher PRA was found in 40 % of them. Although no correlation between the plasma BNP levels and PRA was found (
p
= 0.36), after adjusting for hemodynamic parameters, eGFR and medication, a correlation was found between them (
p
= 0.01). Elevated RAAS factors were found in a substantial number of ADHF patients with high plasma BNP levels in the association with hemodynamic state, which predicts poor clinical outcomes. The measurements of RAAS factors help to stratify ADHF patients at risk for further CV events.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>25964073</pmid><doi>10.1007/s00380-015-0688-7</doi><tpages>7</tpages></addata></record> |
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| ispartof | Heart and vessels, 2016-06, Vol.31 (6), p.925-931 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Acute Disease Aged Aged, 80 and over Aldosterone - blood Area Under Curve Biomarkers - blood Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Clinical outcomes Female Heart failure Heart Failure - blood Heart Failure - diagnosis Heart Failure - physiopathology Heart Failure - therapy Hemodynamics Humans Japan Male Medicine Medicine & Public Health Middle Aged Natriuretic Peptide, Brain - blood Original Article Peptides Predictive Value of Tests Renin - blood Renin-Angiotensin System Retrospective Studies ROC Curve Studies Treatment Outcome Up-Regulation Vascular Surgery |
| title | The predictability of renin–angiotensin–aldosterone system factors for clinical outcome in patients with acute decompensated heart failure |
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