Abstract 14714: Association of Plasma Renin and Aldosterone Levels With Future Left Ventricular Structure and Function: The Multi-Ethnic Study of Atherosclerosis (MESA)
Introduction: The renin-angiotensin-aldosterone-system (RAAS) has been implicated in left ventricular (LV) hypertrophy and dysfunction. We explore the association of circulating levels of plasma renin activity (PRA) and aldosterone to subclinical measures of LV structure and function from MRI.
Methods: The MESA study enrolled 6814 participants free of cardiovascular disease at baseline (2000-2002). We included MESA participants who had blood assayed for measurement of PRA and aldosterone levels at the second/third follow-up exams (2003-2005) and underwent MRI at the fifth follow-up exam (2010 -2012). We excluded participants on hypertension medication (N=509). Harmonic phase analysis was used to compute circumferential strain and torsion from tagged MRI; LV function and structure measures were obtained from cine images. Linear regression evaluated the relationship between PRA, aldosterone and aldosterone to renin ratio (ARR) with LV structure and function. The models included adjustments for cardiovascular risk factors and demographics at the time of assays (model 1) and at the time of imaging (model 2) separately.
Results: At the time of assays, the participants (N=384) were 59±8 years, 53% male, 43% Caucasian, 13% African-American, 17% Chinese, 28% Hispanic, 4% diabetic, with median levels of PRA 0.56 ng/ml (IQR:0.30-0.97), aldosterone 126 pg/ml (IQR:90-176) and ARR 120 ng/ml to pg/ml (IQR:53-234). Higher PRA was associated with lower LV end-diastolic volume index. Higher PRA was associated with higher mass-volume ratio and torsion. Higher ARR was associated with higher LV volume and lower torsion.
Conclusions: In individuals not on hypertension medications, higher PRA was associated with concentric remodeling and higher torsion 7 years later but not to LV function. Also, higher ARR was associated with eccentric LV chamber remodeling and lower torsion. In conclusion, RAAS activity may be implicated in future concentric/eccentric LV remodeling.
Author Disclosures: B. Ambale Venkatesh: None. K. Yoneyama: None. M. Ostovaneh: None. S. Donekal: None. V.L. Murthy: None. R.V. Shah: None. P. Ouyang: None. C.O. Wu: None. M. Allison: None. R. Tracy: None. D.A. Bluemke: None. J.C. Lima: None.
- © 2015 by American Heart Association, Inc.