AbstractBackground. Hyperactivation of the renin-angiotensin-aldosterone system plays a key role in the development of structural remodeling underlying the atrial fibrillation (AF). Nevertheless, the role of excessive aldosterone production in AF development has not been studied.
Purpose. The study aims to evaluate the aldosterone levels in different forms of AF and sinus rhythm.
Methods. The study included 130 patients (the main group) with non-valvular AF. Of these, 40 (30.8%) patients had permanent, 50 (38.4%) – persistent and 40 (30.8%) – paroxysmal AF. The control group consisted of 40 patients with cardiovascular pathology, who did not have a history of AF episodes. Plasma aldosterone levels were measured by immunoenzyme method. In patients with paroxysmal and persistent AF measurement was perfomed during AF episode before restoration of sinus rhythm. Aldosterone reference values was considered as 40-160 pg/ml.
Results. Aldosterone levels were significantly higher in patients of the main group compared to the control (141.5 ± 41.8 pg/ml vs 105.0 ± 33.1 pg/ml, P < 0.001). It was the highest in paroxysmal and persistent AF and lower – in permanent AF. Hyperaldosteronemia (>160 pg/ml) prevalence was significantly higher among all patients of AF group compared to the control (32.3% vs 7.5%, respectively, P = 0.004), however multiple comparisons showed significant differences between paroxysmal AF (47.5%) and sinus rhythm only.
Conclusion. Plasma aldosterone level is significantly higher in AF compared to sinus rhythm. In patients with paroxysmal and persistent AF it’s concentration is higher than in patients with permanent AF.
