RELATIONSHIP OF ALDOSTERONE AND FIBROSIS MARKERS IN THE PATHOGENESIS OF CHRONIC HEART FAILURE BY THE MIDDLE RANGE EJECTION FRACTION IN DIFFERENT AGE GROUPS
Of particular interest is the study of the mechanisms of development of chronic heart failure (HF), especially with intermediate ejection fraction (HFmrEF) depending on age. Methods. The study involved 80 patients, age 55,7 ± 9,3 years, HFmrEF, I–II functional class (FC) HF. These patients are divided into: 1 group – middle age (MA) – 50.2 ± 4.1 years (n = 40 people); 2 group-elderly (E) 60.4 ± 3.8 years (n = 40 people). Results. In patients with MA, the level of aldosterone (AL) was 23 % higher than in KG (p < 0.01), in patients with E – 204.3 ± 32.6 PG/ml, which is higher than in KG by 33 % (p < 0.01) and than in MA by 14 % (p < 0.05). We have established a high correlation between the AL level and the HF FC r = 0.7819, (p < 0.001). Levels of TIMP-1 collagen balance markers in the group of patients with HFmrEF MA were higher than HFmrEF E (by 26 %, p < 0.01). Levels of MMP-1 in the group of E patients were 22 % higher (p < 0.01) than in MA patients. MMP-9 levels in the E group were significantly higher by 16 % (p < 0.01) than in the MA group. We performed a correlation analysis of the relationship between MMP-9 and TIMP-1, and found a moderate correlation (r = 0.65) in patients with E with HFmrEF. Conclusion: The severity of HF and age, increase the activation of the aldosterone system. Indicators AL HFmrEF higher in patients of advanced age. Elderly patients have degradation of the extracellular matrix, which is confirmed by an increase in MMP-1, MMP-9. The increase in blood TIMP-1 reflects the role of fibroblast formation in the progression of HF symptoms. Levels of AL, MMP, and TIMP-1 can be useful markers for identifying patients at risk of progression of HFmrEF, including as components of a multi-marker approach.
Gosteva E.V., Shepel R.N., Osipova O.A. 2020. Relationship of aldosterone and fibrosis markers in the pathogenesis of chronic heart failure by the middle range ejection fraction in different age groups. Challenges in Modern Medicine, 43 (2): 216–228 (in Russian). DOI 10.18413/2687-0940-2020-43-2-216-228.
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