Relation of aldosterone "escape" despite angiotensin-converting enzyme inhibitor administration to impaired exercise capacity in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy
Relation of aldosterone "escape" despite angiotensin-converting enzyme inhibitor administration to impaired exercise capacity in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy
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DOI：
10.1016/s0002-9149(01)02261-5
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发表时间：
2002-02-15
影响因子：
2.8
通讯作者：
Zardini, P
中科院分区：
文献类型：
--
作者：
Cicoira, M;Zanolla, L;Zardini, P
在慢性充血性心力衰竭（CHF）患者中，尽管使用血管紧张素转换酶（ACE）抑制剂，仍可能产生醛固酮。这种现象被称为醛固酮“逃逸”;其与疾病严重程度的关系尚不清楚。我们试图评估醛固酮逃逸是否可能与CHF患者的疾病严重程度或功能损害有关。141例连续接受ACE抑制剂治疗（>6个月）的CHF患者接受了神经激素激活和身体成分评价、超声多普勒检查和心肺运动试验。醛固酮逃逸定义为血浆醛固酮水平高于我们实验室的正常范围（>0.42 nmol/L）。14例患者（10%）有醛固酮逃逸。在年龄、纽约心脏协会分级、神经激素激活、ACE抑制剂剂量、血流动力学或骨骼肌体积方面，有和无醛固酮逃逸的患者之间没有差异。相反，平均峰值耗氧量（14.2 +/- 3.5 vs 17.3 +/- 4.9 ml/min/kg，p
In patients with chronic congestive heart failure (CHF), aldosterone production may occur despite the administration of angiotensin-converting enzyme (ACE) inhibitors. This phenomenon has been termed aldosterone "escape"; its relation to the severity of the disease is unknown. We sought to assess whether aldosterone escape might be related to disease severity or functional impairment in patients with CHF. One hundred forty-one consecutive patients with CHF who received ACE inhibitors (>6 months) underwent an evaluation of neurohormonal activation and body composition, an echo-Doppler examination, and a cardiopulmonary exercise test. Aldosterone escape was defined as plasma levels of aldosterone above the normal range in our laboratory (>0.42 nmol/L). Fourteen patients (10%) had aldosterone escape. There were no differences between patients with and without aldosterone escape with regard to age, New York Heart Association class, neurohormonal activation, ACE inhibitor dose, hemodynamics, or skeletal muscle bulk. In contrast, mean peak oxygen consumption (14.2 +/- 3.5 vs 17.3 +/- 4.9 ml/min/kg, p