L.M. Babii, N.P. Stroganova, S.Yu. Savythkyi, U.Yu. Ostapchuk. Left ventricular structure and function changes and blood aldosterone levels in remote terms after myocardial infarction

The aim – to explore relationship between blood aldosterone level and left ventricular (LV) structure and function changes in remote terms after myocardial infarction (MI).

Material and methods. The study included 66 patients (62 men and 4 women), age range 20–70 years (mean age (55.2±1.6) years) after Q-wave MI, follow-up duration was 2 years. Aldosterone levels in peripheral blood were determined using radioimmunoassay kits for microanalysis. All patients underwent echocardiography with key indicators. Following groups of patients were formed: 1st (n=19) – preserved systolic (LVEF more than 45 %) and pump (stroke volume greater than 55 ml) LV function without arterial hypertension (AH); 2nd (n=31) – patients with preserved systolic and pump left ventricular function and AH; 3rd (n=16) – reduced LV systolic function (ejection fraction less than 45 %) with AH. Depending on aldosterone level, subgroups were identified in the 1st and 2nd groups.

Results. High levels of aldosterone exceeding normal ones by 2.0–2.5 times were recorded in all patients of the 3rd group. Blood level of aldosterone was related to the hemodynamic changes in the study groups. After two years of follow-up the level of aldosterone was significantly related to the end-diastolic volume (r=0.47), end-systolic volume (r=0.57), myocardial mass index (r=0.42), and negatively related to the left ventricular ejection fraction (r=–0.50).

Conclusions. After myocardial infarction increased aldosterone levels play an important role in the violation of systolic and diastolic LV function and development of heart failure. This makes necessary to determine blood aldosterone level and creates background for use of aldosterone antagonists.

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