Pulmonary Vascular Disease |

Circulating Aldosterone Levels and Disease Severity in Pulmonary Arterial Hypertension FREE TO VIEW

Zeenat Safdar, MD; Aishwarya Thakur; Guffey Daniella, BS; Charles Minard, PhD; Yingqun Ji
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Baylor College of Medicine, Houston, TX; First Affiliated Hospital of Dalian Medical, Dalian, Liaoning, China

Chest. 2015;148(4_MeetingAbstracts):938A. doi:10.1378/chest.2280635
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SESSION TITLE: Pulmonary Arterial Hypertension Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: It is not known whether aldosterone levels are associated with disease severity in patients with pulmonary arterial hypertension (PAH). The goal of this study was to determine whether circulating aldosterone levels can predict the severity of PAH in terms of hemodynamic characteristics and mortality.

METHODS: Data on patients with stable PAH who had aldosterone levels drawn as part of clinical care data was reviewed from 08/2000 to 06/2013. The plasma levels of aldosterone and BNP were collected. Clinical, hemodynamic, and outcome data was collected at the time of the clinic visit when aldosterone was drawn. Mean follow up time of 39 ± 101.79 months was observed. Data on time to death were examined by Kaplan-Meier survival curves.

RESULTS: There are 125 PAH patients with plasma aldosterone levels. Median level of aldosterone and BNP were 9.9 pg/ml (25th-75th percentile: 4.1 pg/ml, 27.1 pg/ml) and 67.5 pg/ml (25th-75th percentile: 31 pg/ml, 225 pg/ml), respectively. The aldosterone level was not significantly associated with BNP, 6 minute walk distance, Borg dyspnea score, right ventricular systolic pressure, right atrial pressure, cardiac output and cardiac index. However, the association between aldosterone and RAP significantly dependent on MR blocker treatment (Coef. =2.88, 95CI: 1.19, 4.56, p=0.001). By log-rank statistic there was not statistical difference between the survival of the aldosterone categories by median (p=0.914). However, there was a significant difference in survival between the BNP categories (p<0.001) such that those with high BNP level (>180 pg/mL) had a lower survival time.

CONCLUSIONS: The aldosterone level is not associated increased mortality in PAH but a marker of disease severity.

CLINICAL IMPLICATIONS: High aldosterone levels may be an indicator of worse disease in pulmonary hypertension.

DISCLOSURE: Zeenat Safdar: University grant monies: NIH-NHLBI, Consultant fee, speaker bureau, advisory committee, etc.: gilead, united therapeutics, actelion, bayer, intermmune, University grant monies: gilead, united therapeutics, actelion, bayer, intermmune The following authors have nothing to disclose: Aishwarya Thakur, Yingqun Ji, guffey Daniella, Charles Minard

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