Abstract 15658: Arginine-vasopressin Levels Are Increased in Heart Failure With Preserved Ejection Fraction and Correlate With LV Hypertrophy
Abstract: Arginine-Vasopressin (AVP) exerts a variety of effects. in addition to its antidiuretic effect via V2 receptors in the kidneys, AVP has vasoconstrictive effects via its action on V1a receptors in the peripheral vasculature. Whether patients with heart failure and preserved ejection fraction (HFpEF) demonstrate increased levels of AVP, and whether this relates to left ventricular remodeling is unknown.
Methods: We studied 26 subjects with heart failure and reduced ejection fraction (HFrEF), 28 subjects with HFpEF, and 95 control subjects without heart failure. AVP was measured ELISA (Cayman Chemicals ; USA). In a subgroup of subjects (n=110) we measured LV mass with magnetic resonance imaging (SSFP cine sequences), with LV segmentation using CMR42 (Circle CV Imaging; Calgary, Canada).
Results: AVP levels were significantly greater in HFpEF (1.01; 95%CI=0.84 to 1.19)Compared to either HFrEF (0.72; 95%CI=0.58 to 0.87) or controls without HF (0.69; 95%CI=0.62 to 0.75; ANOVA P<0.0001). After adjustment for age, gender, race/ethnicity, systolic blood pressure, body mass index, use of ACE inhibitors, angiotensin receptor blockers, spironolactone and beta blockers, HFpEF remained an independent predictor of greater AVP levels (Beta=0.28 pg/mL; P=0.003). In the overall population AVP levels were associated with a greater LV mass (Standardized beta=0.25; P=0.008), after adjustment for heart failure group membership. This relationship persisted after further adjustment for blood pressure, age, gender, race, medication use, diabetes mellitus and body mass index (Standardized beta=0.21; P=0.027).
Conclusions: AVP is increased in HFpEF and is associated with LV hypertrophy. Further research is required to assess whether this relationship is causal and whether AVP antagonism is a suitable therapeutic strategy in HFpEF.
Author Disclosures: J.A. Chirinos: Research Grant; Significant; NIH, American College of Radiology Network, Fukuda Denshi, Bristol Myers Squibb, Microsoft and CVRx Inc. Other Research Support; Modest; Fukuda Denshi, Withings, Atcor Medical. Consultant/Advisory Board; Modest; Fukuda Denshi, Microsoft Research, Merck and Vital Labs. Consultant/Advisory Board; Significant; Bristol Myers Squibb, OPKO Healthcare. A. Syed: None. H. Soto-Calderon: None. I. Vassim: None. S. Varakantam: None. M.R. Koppula: None. S.R. Akers: None. A.Y. Bagrov: None. W. Wei: None. E.G. Lakatta: None. O. Fedorova: None.
- © 2016 by American Heart Association, Inc.