Evidence map›Paper›PMID 26586488›Full record

ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2016

Elevated pulmonary arterial and systemic plasma aldosterone levels associate with impaired cardiac reserve capacity during exercise in left ventricular systolic heart failure patients: A pilot study.

Bradley A Maron, Thomas E Stephens, Laurie A Farrell, William M Oldham, Joseph Loscalzo, Jane A Leopold, Gregory D Lewis

Open access · greenAbstract read
In one paragraph

Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Bradley A MaronDivision of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Cardiology, Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts.
Thomas E StephensDivision of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Laurie A FarrellDivision of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
William M OldhamDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Joseph LoscalzoDivision of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Jane A LeopoldDivision of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Gregory D LewisDivision of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. Electronic address: glewis@partners.orrg.
Brigham and Women's Hospital · USHarvard University · USMassachusetts General Hospital · US

Funding

Tissue AnalysesP01HL048743 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MICHEL, THOMAS · 1992 to 2014
$26.3M
RESPIRATORY RESEARCHT32HL007633 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI George R Washko · 1985 to 2026
$14.9M
TRANSLATIONAL PHARMACOLOGY COREP50GM107618 · NIGMS · HARVARD MEDICAL SCHOOL · PI MALISZEWSKI, LAURA ELIZABETH · 2014 to 2018
$10.8M
GPx-3 and Peroxide Flux in the Endothelial CellR37HL061795 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI LOSCALZO, JOSEPH · 2007 to 2016
$4.3M
Targeting FAK-NEDD9 protein-protein interaction to prevent focal adhesion assembly and vascular proliferation in pulmonary arterial hypertensionR01HL139613 · NHLBI · UNIVERSITY OF MARYLAND BALTIMORE · PI Sirano Dhe-Paganon, Bradley Maron · 2018 to 2026
$4.1M
Harvard Regional Clinical Center of the NHLBI Heart Failure NetworkU10HL110337 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI GIVERTZ, MICHAEL M, LEWIS, GREGORY DYER · 2012 to 2018
$3.5M
The Phathophenotype Landscape of Complex DiseaseU01HL108630 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI LOSCALZO, JOSEPH · 2011 to 2014
$2.7M
Intergrated Endothelial Phenotyping to Redefine Pulmonary HypertensionU01HL125215 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI LEOPOLD, JANE A, WAXMAN, AARON B · 2014 to 2018
$1.7M
PLATELET DERIVED REACTIVE OXYGEN SPECIES AND PLAQUER01HL061795 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI LOSCALZO, JOSEPH · 1998 to 2006
$1.6M
Aldosterone impairs endothelin B-dependent synthesis of nitric oxide to promote pK08HL111207 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MARON, BRADLEY · 2013 to 2017
$754k
PITCH HF Right Ventricular Pulmonary Vascular Reserve Ancillary StudyR01HL119154 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI LEWIS, GREGORY DYER · 2013 to 2013
$304k
NHLBI NIH HHS HL048743,NHLBI NIH HHS HL061795,NHLBI NIH HHS HL108630,NHLBI NIH HHS K08 HL111207NHLBI NIH HHS K08-HL1-11207-01A1NHLBI NIH HHS R01 HL119154NHLBI NIH HHS R01-HL1-19154NHLBI NIH HHS R01 HL139613NHLBI NIH HHS T32 HL007633NHLBI NIH HHS T32-HL-007633NHLBI NIH HHS U01 HL125215NHLBI NIH HHS U10 HL110337NHLBI NIH HHS U10-HL1-10337NIGMS NIH HHS GM107618PHS HHS R01-105301PHS HHS U01-1252151
6 · The paper itself

Abstract

backgroundElevated levels of aldosterone are a modifiable contributor to clinical worsening in heart failure with reduced ejection fraction (HFrEF). Endothelin-1 (ET-1), which is increased in HFrEF, induces pulmonary endothelial aldosterone synthesis in vitro. However, whether transpulmonary aldosterone release occurs in humans or aldosterone relates to functional capacity in HFrEF is not known. Therefore, we aimed to characterize ET-1 and transpulmonary aldosterone levels in HFrEF and determine if aldosterone levels relate to peak volume of oxygen uptake (pVO2).

methodsData from 42 consecutive HFrEF patients and 18 controls referred for invasive cardiopulmonary exercise testing were analyzed retrospectively.

resultsRadial ET-1 levels (median [interquartile range]) were higher in HFrEF patients compared with controls (17.5 [11.5-31.4] vs 11.5 [4.4-19.0] pg/ml, p = 0.04). A significant ET-1 transpulmonary gradient (pulmonary arterial [PA] - radial arterial levels) was present in HFrEF (p < 0.001) but not in controls (p = 0.24). Compared with controls, aldosterone levels (median [interquartile range]) were increased in HFrEF patients in the PA (364 [250-489] vs 581 [400-914] ng/dl, p < 0.01) and radial compartments (366 [273-466] vs 702 [443-1223] ng/dl, p < 0.001). Akin to ET-1, a transpulmonary increase (median [interquartile range]) in aldosterone concentration was also observed between controls and HFrEF patients at rest (7.5 [-54 to 40] vs 61.6 [-13.6 to 165] ng/dl, p = 0.01) and peak exercise (-20.7 [-39.6 to 79.1] vs 25.8 [-29.2 to 109.3] ng/dl, p = 0.02). The adjusted pVO2 correlated inversely with aldosterone levels at peak activity in the PA (r = -0.31, p = 0.01) and radial artery (r = -0.32, p = 0.01).

conclusionsThese data provide preliminary evidence in support of increased transpulmonary aldosterone levels in HFrEF and suggest an inverse relationship between circulating aldosterone and pVO2. Future prospective studies are needed to characterize the functional effects of transpulmonary and circulating aldosterone on cardiac reserve capacity in HFrEF.

Indexed as

ExerciseFractional Flow Reserve, MyocardialAdolescentAdultAgedAged, 80 and overAldosteroneEndothelin-1FemaleHeart Failure, SystolicHumansMaleMiddle AgedPilot ProjectsPulmonary ArteryRetrospective StudiesAldosteroneEndothelin-1aldosteronecardiac reserveexerciseheart failurereduced ejection fraction

Identifiers

PMID26586488
PMCPMC4789151
OpenAlexW2183830702

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.