Association Between Hyperaldosteronemia and Electrophysiological Myocardial Activity in Heart Failure with Preserved Ejection Fraction

Background. Sudden cardiac death, one of the most common types of cardiac death, is most often triggered by ventricular arrhythmia. Plasma aldosterone level has been shown to be an independent risk factor of life-threatening ventricular arrhythmia in patients with left ventricular systolic dysfunction following acute myocardial infarction. Whether either effect also occurs in patients with heart failure and preserved ejection fraction is currently unknown. Purpose. The study aims to investigate the relationship between plasma aldosterone level and ventricular arrhythmias in longterm heart failure with preserved ejection fraction. Methods. A cross-sectional study included 158 patients (58 men and 100 women, mean age 62.3±7.4 years) with heart failure with preserved ejection fraction (> 50%). Patients had no history of primary aldosteronism and did not use the mineralocorticoid receptor antagonists during the last 6 weeks. Aldosterone plasma level was measured and 24-hour electrocardiographic monitoring was performed. Results. According to laboratory results 99 patients (62.7%, 95% confidence interval 55.0-70.0%) had normal (40-160 pg/ml) aldosterone plasma level (nAld) and 59 patients (37.3%, 95% CI 30.0-45.0%) had high (> 160 pg/ml) aldosterone level (hAld). hAld patients more often had QTc prolongation (44.1% versus 18.2%) and ventricular arrhythmias (83.1% vs 61.6%) compared to nAld patients (all Ps <0.001). The number of ventricular premature complexes in 24 hours were higher in hAld group (median 214, range 64-758) compared to nAld (median 52, range 16-198, P < 0.003). hAld patients more often occurred bigemy, couple ventricular ectopy and nonsustained ventricular tachycardia (39.0% vs 19.0%, р=0.01). In Cox regression model’s high aldosterone plasma level was the independent risk factors of QTc prolongation (odds ratio 1.6, 95% confidence interval 1.1-5.7, p=0.034) and prognostically unfavorable ventricular arrhythmias (odds ratio 1.8, 95% confidence interval 1.2-6.8, p=0.024). Conclusion. In long-term HFpEF plasma aldosterone level is significantly related to QTc prolongation as well as ventricular arrhythmias.

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P480Aldosterone plasma level as risk factor of ventricular arrhythmias in heart failure with preserved ejection fraction

EP Europace ◽

10.1093/europace/euaa162.121 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

A Shevelyok ◽

N Vatutin

Keyword(s):

Plasma Level ◽

Ventricular Arrhythmias ◽

Left Ventricular ◽

Plasma Aldosterone ◽

Preserved Ejection Fraction ◽

Qtc Prolongation ◽

Aldosterone Level ◽

History Of ◽

Plasma Aldosterone Level

Abstract Background. Sudden cardiac death, one of the most common types of cardiac death, is most often triggered by ventricular arrhythmia. Plasma aldosterone level has been shown to be an independent risk factor of life-threatening ventricular arrhythmia in patients with left ventricular systolic dysfunction following acute myocardial infarction. Whether either effect also occurs in patients with heart failure and preserved ejection fraction (HFpEF) is currently unknown. Purpose. The study aims to investigate the relationship between plasma aldosterone level and ventricular arrhythmias in long-term HFpEF. Methods. The study included 158 patients (58 men and 100 women, mean age 62.3 ± 7.4 years) with HFpEF (> 50%). All patients had a history of hospitalization due to HFpEF during the last 12 months, left ventricular diastolic dysfunction and / or elevated NT-proBNP level. Median confirmed HFpEF duration was 5 (range 4-8) years. Patients had no history of primary aldosteronism and did not use the mineralocorticoid receptor antagonists during the last 6 weeks. Aldosterone plasma level was measured and 24-hour electrocardiographic monitoring was performed. Results. According to laboratory results 99 patients (67.1%, 95% confidence interval (CI) 59.6-74.2%) had normal (40-160 pg/ml) aldosterone plasma level (nAld) and 59 patients (37.3%, 95% CI 30.0-45.0%) had high (> 160 pg/ml) aldosterone level (hAld). hAld patients more often had QTc prolongation (44.1% versus 18.2%) and ventricular arrhythmias (83.1% vs 61.6%) compared to nAld patients (all Ps < 0.001). The number of ventricular premature complexes in 24 hours was higher in hAld group (median 214, range 64-758) compared to nAld (median 52, range 16-198, P < 0.003). hAld patients more often occurred bigemy, couple ventricular ectopy and nonsustained ventricular tachycardia (39.0% vs 19.0%, P = 0.01). In Cox regression models high aldosterone plasma level was the independent risk factors of QTc prolongation (odds ratio (OR) 1.6, 95% CI 1.1-5.7, P = 0.034) and prognostically unfavorable ventricular arrhythmias (OR 1.8, 95% CI 1.2-6.8, P = 0.024). Conclusion. In long-term HFpEF plasma aldosterone level is significantly related to QTc prolongation as well as ventricular arrhythmias.

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Hyperaldosteronemia as a risk factor of renal dysfunction in patients with heart failure with preserved ejection fraction

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2020-48-058 ◽

2020 ◽

Vol 48 (5) ◽

pp. 316-324

Author(s):

A. N. Shevelok

Keyword(s):

Heart Failure ◽

Renal Function ◽

Plasma Level ◽

Confidence Interval ◽

Ejection Fraction ◽

Odds Ratio ◽

Plasma Aldosterone ◽

Preserved Ejection Fraction ◽

Increased Risk ◽

Patients With Heart Failure

Objective: To assess the relationship between plasma aldosterone levels and renal function in patients with heart failure with preserved ejection fraction (HFpEF).Materials and methods: A cross-sectional study included 158 patients with confirmed HFpEF. Patients with primary hyperaldosteronism, edema syndrome, end stage renal disease and taking mineralocorticoid receptor antagonists were excluded. Renal function was assessed by determining daily urinary albumin excretion (UAE) and calculating the glomerular filtration rate (GFR). Plasma aldosterone was measured by enzyme immunoassay.Results: The patients were divided into two groups: 99 patients had normal (40-160 pg/ml) aldosterone plasma level (nAld) and 59 patients had high (> 160 pg/ml) aldosterone level (hAld). hAld patients had significantly higher UAE (median 342 mg/day [interquartile value 253; 453] versus 116 mg/day [32; 255], p < 0.001), and lower GFR (52 ml/min/1.73 m2 [46; 67.5] versus 66 ml/min/1.73 m2 [53; 79]) compared to nAld. The prevalence of impaired renal filtration function and severe albuminuria was higher in hAld group then in nAld (p < 0.001). In binomial logistic regression models adjusted for age, severity of HFpEF and comorbidities high aldosterone plasma level were independent risk factors of significant (< 60 ml/min/1.73 m2) decrease in GFR (odds ratio 4.25, 95% confidence interval 2.01-16.6) and very high (> 300 mg/day) albuminuria (odds ratio 2.23, 95% confidence interval 1.24-9.63).Conclusion: In HFpEF plasma aldosterone levels are closely related to renal function. Secondary hyperaldosteronism is associated with an increased risk of impaired renal filtration and severe albuminuria.

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Prognostic value of secondary hyperaldosteronism in patients with chronic heart failure with preserved ejection fraction

Medical Herald of the South of Russia ◽

10.21886/2219-8075-2021-12-2-81-91 ◽

2021 ◽

Vol 12 (2) ◽

pp. 81-91

Author(s):

A. N. Shevelok

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Prognostic Value ◽

Functional Class ◽

Plasma Aldosterone ◽

Preserved Ejection Fraction ◽

Aldosterone Level ◽

Patients With Heart Failure ◽

Secondary Hyperaldosteronism ◽

Plasma Aldosterone Level

Purpose: to investigate the prognostic value of secondary hyperaldosteronism patients with heart failure with preserved ejection fraction. Materials and methods: prospective cohort study included 158 patients with hyperaldosteronism and heart failure with preserved ejection fraction. Baseline blood aldosterone levels were determined in all patients. Hyperaldosteronemia was diagnosed when the plasma aldosterone level was > 160 pg/ml. The primary endpoint was all-cause mortality. Results: at baseline, hyperaldosteronemia was detected in 59 of 158 patients (37.3%). Hyperaldosteronemic patients were younger, had higher functional class and NT-proBNP level, and a higher rate of comorbidity (all Ps <0.05). Over a median follow‐up of 32 (28-38) months, a total of 50 (37.6%) patients died. Cardiovascular death occurred in 32 (20.3%) cases, non-cardiovascular – in 18 (11.4%) cases. A total of 65 (41.1%) patients were hospitalized for HF. High aldosterone levels were associated with a significant (p <0.05) increase in the risk of hospitalization for HF (adjusted odds ratio (OR) 2.14, 95% confidence interval (CI) 1.34-9.68), all-cause death (OR 1.64; 95% CI 1.23-7.65, P = 0.033) and HF death (OR 1.56; 95 % CI 1.14-11.3, P = 0.021). Conclusion: Hyperaldosteronism in patients with heart failure with preserved ejection fraction secondary hyperaldosteronism is an independent predictor of hospitalization for heart failure, all-cause, and cardiovascular mortality. The inclusion of plasma aldosterone level in the existing prognosis models of heart failure with preserved ejection fraction will help improve their predictive value and optimize the management of high-risk patients.

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Abstract 17311: Ventricular Arrhythmias and Fibrosis in Patients With Heart Failure and Preserved Ejection Fraction

Circulation ◽

10.1161/circ.142.suppl_3.17311 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Natasha Cuk ◽

Jae H Cho ◽

Donghee Han ◽

Joseph E Ebinger ◽

Eugenio Cingolani

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Cardiac Mri ◽

Ventricular Arrhythmias ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Preserved Ejection Fraction ◽

Ventricular Ejection Fraction ◽

Patients With Heart Failure ◽

Ventricular Fibrosis

Introduction: Sudden death due to ventricular arrhythmias (VA) is one of the main causes of mortality in patients with heart failure and preserved ejection fraction (HFpEF). Ventricular fibrosis in HFpEF has been suspected as a substrate of VA, but the degree of fibrosis has not been well characterized. Hypothesis: HFpEF patients with increased degree of fibrosis will manifest more VA. Methods: Cedars-Sinai medical records were probed using Deep 6 artificial intelligence data extraction software to identify patients with HFpEF who underwent cardiac magnetic resonance imaging (MRI). MRI of identified patients were reviewed to measure extra-cellular volume (ECV) and degree of fibrosis. Ambulatory ECG monitoring (Ziopatch) of those patients were also reviewed to study the prevalence of arrhythmias. Results: A total of 12 HFpEF patients who underwent cardiac MRI were identified. Patients were elderly (mean age 70.3 ± 7.1), predominantly female (83%), and overweight (mean BMI 32 ± 9). Comorbidities included hypertension (83%), dyslipidemia (75%), and coronary artery disease (67%). Mean left ventricular ejection fraction by echocardiogram was 63 ± 8.7%. QTc as measured on ECG was not significantly prolonged (432 ± 15 ms). ECV was normal in those patients for whom it was available (24.2 ± 3.1, n = 9) with 3/12 patients (25%) demonstrating ventricular fibrosis by MRI (average burden of 9.6 ± 5.9%). Ziopatch was obtained in 8/12 patients (including all 3 patients with fibrosis) and non-sustained ventricular tachycardia (NSVT) was identified in 5/8 (62.5%). One patient with NSVT and without fibrosis on MRI also had a sustained VA recorded. In those patients who had Ziopatch monitoring, there was no association between presence of fibrosis and NSVT (X2 = 0.035, p = 0.85). Conclusions: Ventricular fibrosis was present in 25% of HFpEF patients in this study and NSVT was observed in 62.5% of those patients with HFpEF who had Ziopatch monitoring. The presence of fibrosis by Cardiac MRI was not associated with NSVT in this study; however, the size of the cohort precludes broadly generalizable conclusions about this association. Further investigation is required to better understand the relationship between ventricular fibrosis by MRI and VA in patients with HFpEF.

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P3512Sex differences in rats with heart failure with preserved ejection fraction and the effect of autonomic modulation

European Heart Journal ◽

10.1093/eurheartj/ehz745.0376 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

S Stavrakis ◽

K Elkholey ◽

L Morris ◽

Y Li ◽

S S Po

Keyword(s):

Heart Failure ◽

Sex Differences ◽

Sudden Death ◽

Ejection Fraction ◽

Female Rats ◽

Autonomic Modulation ◽

Preserved Ejection Fraction ◽

Qtc Prolongation ◽

Male And Female ◽

Male And Female Rats

Abstract Background Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for 50% of HF and sudden death is the leading cause of mortality. There are considerable sex differences in cardiac structure and function, which may be related to outcomes in HFpEF. Transcutaneous vagus nerve stimulation (tVNS) is antiarrhythmic. Purpose To describe sex differences in mortality, autonomic tone and ECG parameters in rats with HFpEF and examine the effect of tVNS on these outcomes. Methods Dahl salt sensitive (DS) rats of either sex were randomized into high salt (HS, 8% NaCl) or low salt (LS) diet (0.3% NaCl) at 7 weeks of age. After 6 weeks of LS or HS diets, HS rats were randomized to receive active or sham tVNS, 30min daily (20Hz, 3mA) for 4 weeks. The rats were monitored daily for 4 weeks for the development of HFpEF. ECG and echocardiogram were performed at 13 weeks (baseline) and 17 weeks (endpoint). Heart rate variability (HRV) was calculated at the respective time points. ECG and HRV parameters were analyzed in a blinded fashion. Logistic regression analysis was performed to identify independent predictors of mortality. Results A total of 58 rats were included (5 male LS, 6 female LS, 22 male HS and 25 female HS). HS rats developed significant hypertension and signs of HFpEF, while 24% of females and 53% of males died (P=0.004). There were 4 sudden cardiac deaths in males (with ventricular tachycardia documented in 1 rat), whereas all the females died of HF or stroke. Corrected QT (QTc) at baseline significantly prolonged in HS compared to LS rats (250.5±14.4ms vs. 226.8±13.9ms, respectively, p=0.0007), while all other ECG parameters did not differ significantly between groups. In HS rats, QTc prolongation was significantly more pronounced in males compared to females (259.4±20.6ms vs. 243.8±14.5ms, respectively, P=0.002). In univariate analysis, prolonged baseline QTc (OR=1.04; 95% CI 1.01–1.06, p=0.003) and male sex (OR=3.21, 95% CI 1.19–8.66, p=0.016) predicted mortality. However, in multivariate analysis, QTc was the only significant predictor of mortality (OR=1.04; 95% CI 1.01–1.06, p=0.003). After 4 weeks of treatment, active tVNS significantly decreased QTc compared to sham (244.6±13.8ms vs. 255.8±14.0ms, respectively, p=0.017) in both male and female rats in a similar manner. The low frequency to high frequency ratio (LF/HF) of HRV, which reflects sympathovagal balance, was significantly decreased in active tVNS rats compared to sham (0.21±0.13 vs. 0.54±0.14, respectively; p=0.001) in both male and female rats in a similar manner. Conclusions Male rats with HFpEF exhibit worse survival compared to females and are at higher risk for sudden death. QTc prolongation accounts for the increased risk of sudden death in males compared to females. Autonomic modulation with tVNS attenuates the unfavorable changes in QTc and HRV induced by HS diet and may be used to prevent ventricular arrhythmias in patients with HFpEF.

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Ventricular Arrhythmias Underlie Sudden Death in Rats With Heart Failure and Preserved Ejection Fraction

Circulation Arrhythmia and Electrophysiology ◽

10.1161/circep.118.006452 ◽

2018 ◽

Vol 11 (8) ◽

Cited By ~ 11

Author(s):

Jae Hyung Cho ◽

Rui Zhang ◽

Stephan Aynaszyan ◽

Kevin Holm ◽

Joshua I. Goldhaber ◽

...

Keyword(s):

Heart Failure ◽

Sudden Death ◽

Ejection Fraction ◽

Ventricular Arrhythmias ◽

Preserved Ejection Fraction

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The impact of frailty and aging on prognosis in patients with heart failure with preserved ejection fraction – insights from PURSUIT-HFpEF registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.0961 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Okada ◽

K Inoue ◽

T Onishi ◽

K Iwakura ◽

T Yamada ◽

...

Keyword(s):

Heart Failure ◽

Confidence Interval ◽

Ejection Fraction ◽

Hazard Ratio ◽

Adverse Outcomes ◽

Funding Source ◽

Preserved Ejection Fraction ◽

Clinical Endpoint ◽

Patients With Heart Failure

Abstract Introduction Frailty and aging are two common conditions both associated with increased vulnerability to stressful events with high risk of adverse outcomes. Purpose To evaluate the association between frailty and aging and their impacts on clinical outcome in patients with heart failure with preserved ejection fraction (HFpEF). Methods Analysis was performed from a prospective multicenter observational registry for HFpEF (PURSUIT-HFpEF Registry) conducted in the Osaka region of Japan. A total of 757 patients hospitalized for acute heart failure (diagnosed by using Framingham criteria) met the inclusion criteria: a left ventricular ejection fraction ≥50% and brain natriuretic peptide ≥100pg/ml. We included 483 patients (age, 80±9 years; men, 45%; atrial fibrillation, 35%) whose follow-up data after survival discharge were available. Patients' frailty and aging were evaluated using the clinical frailty scale (CFS) and age quartiles (Q1: <76 years (n=122), Q2: 76–82 years (n=111), Q3: 82–87 years (n=127), Q4: >87 years (n=123)), respectively. The primary clinical endpoint was defined as the composite of death, re-hospitalization for heart failure, and cerebrovascular accident. Results The median (interquartile range) CFS rating was 3 (2–5), and there was a little correlation between CFS rating and age (r2=0.16, p<0.001). The prevalence of frailty, defined as a CFS rating >4 (n=132), was positively correlated with age quartiles (Q1: 9.0%, Q2: 21.4%, Q3: 29.9%, Q4: 48.0%, p<0.001). During the median follow-up period 396 days (interquartile range, 344–698) after discharge, the clinical endpoint was observed in 172 patients. The incidence was higher in patients with frailty than those without it (49.6% vs. 30.4%, log-rank p<0.001). It was also correlated with age quartiles (Q1: 23.0%, Q2: 34.2%, Q3: 36.2%, Q4: 48.8%, log-rank p=0.001). Multivariate Cox regression analysis revealed that frailty (hazard ratio, 1.52; 95% confidence interval, 1.09–2.10; p=0.013) and age (hazard ratio per quartile increase, 1.24; 95% confidence interval, 1.07–1.43; p=0.004) were both associated with the clinical endpoint. Subgroup analysis in 352 patients without frailty also revealed the significant impact of age on the endpoint (1.26; 1.06–1.51; p=0.008). However, in 131 patients with frailty, there was no significant impact of age on the endpoint (1.16; 0.90–1.51; p=0.25). Conclusions Frailty was common and was associated with aging in HFpEF patients. Although they were both associated with unfavorable events, aging was no longer a significant predictor of adverse outcomes under the frailty conditions. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Roche Diagnostics K.K. and Fuji Film Toyama Chemical Co. Ltd.

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Delayed Repolarization Underlies Ventricular Arrhythmias in Rats With Heart Failure and Preserved Ejection Fraction

Circulation ◽

10.1161/circulationaha.117.028202 ◽

2017 ◽

Vol 136 (21) ◽

pp. 2037-2050 ◽

Cited By ~ 24

Author(s):

Jae Hyung Cho ◽

Rui Zhang ◽

Peter J. Kilfoil ◽

Romain Gallet ◽

Geoffrey de Couto ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Ventricular Arrhythmias ◽

Preserved Ejection Fraction

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Association of admission and discharge anemia status with outcomes in patients hospitalized for acute decompensated heart failure: Differences between patients with preserved and reduced ejection fraction

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872617730039 ◽

2017 ◽

Vol 8 (7) ◽

pp. 606-614 ◽

Cited By ~ 1

Author(s):

Katsuya Kajimoto ◽

Yuichiro Minami ◽

Shigeru Otsubo ◽

Naoki Sato

Keyword(s):

Heart Failure ◽

Confidence Interval ◽

Ejection Fraction ◽

Primary Endpoint ◽

Acute Decompensated Heart Failure ◽

Decompensated Heart Failure ◽

Hazard Ratio ◽

Preserved Ejection Fraction ◽

Reduced Ejection Fraction ◽

Heart Failure Patients

Background: In acute decompensated heart failure patients with a preserved or reduced ejection fraction, the association of admission and discharge anemia status with outcomes remains unclear. Methods and results: Of the 4842 patients enrolled in the Acute Decompensated Heart Failure Syndromes (ATTEND) registry, 4433 patients (2017 with a preserved and 2416 with a reduced ejection fraction) were examined to investigate associations among the anemia status at admission and discharge (no anemia, developed anemia, resolved anemia, or persistent anemia), a preserved or reduced ejection fraction and the primary endpoint (all-cause death and readmission for heart failure). In the preserved ejection fraction group, adjusted analysis showed that either developed or persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.53; 95% confidence interval (CI): 1.11–2.11; p=0.009 and hazard ratio: 1.60; 95% CI: 1.26–2.04; p<0.001, respectively), but there was no association between resolved anemia and the primary endpoint (hazard ratio: 0.98; 95% CI: 0.67–1.45; p=0.937). In the reduced ejection fraction group, either developed or resolved anemia was associated with a tendency toward higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.29; 95% CI: 0.95–1.62; p=0.089, and hazard ratio: 1.31; 95% CI: 0.96–1.77; p=0.085, respectively), while persistent anemia was associated with a significantly higher risk of the primary endpoint relative to no anemia (hazard ratio: 1.36; 95% CI: 1.12–1.65; p=0.002). Conclusions: In acute decompensated heart failure patients, the association of admission and discharge anemia status with outcomes differs markedly between patients with a preserved or reduced ejection fraction.

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Relationship between aldosterone and lipids plasma levels in patients with chronic heart failure with preserved ejection fraction

Practical medicine ◽

10.32000/2072-1757-2021-2-70-76 ◽

2021 ◽

Vol 19 (2) ◽

pp. 70-76

Author(s):

A. N. SHEVELOK ◽

Keyword(s):

Heart Failure ◽

Body Mass Index ◽

Plasma Level ◽

Ejection Fraction ◽

Body Mass ◽

Significant Risk ◽

Reference Value ◽

Preserved Ejection Fraction ◽

Cross Sectional ◽

Blood Profile

The purpose — to determine the relationship between aldosterone plasma level and lipid blood profile in patients with heart failure with preserved ejection fraction (HFpEF). Material and methods. A cross-sectional study was carried out with 158 patients with stable HFpEF. Aldosterone plasma level was measured by immunoenzyme method with the reference value of 40–160 pg/ml. The assay of lipid blood profile included measurement of total cholesterol (TC), low (LDL-C) and high density (HDL-C) lipoprotein cholesterol and triglycerides (TG). Results. According to laboratory results, 99 patients (62,7%, 95% confidence interval (CI) 55–70%) had normal (40–160 pg/ml) aldosterone plasma level (nAld) and 59 patients (37,3%, 95% CI 30–45%) had high (>160 pg/ml) aldosterone level (hAld). Levels of TC, LDL-C and TG in hAld group were significantly higher compared to nAld (p < 0,001). Correlation analysis showed significant (all Ps < 0,001) positive correlation between aldosterone and TC (r = 0,66), LDL cholesterol (r = 0,59), TG (r = 0,74) and body mass index (r = 0,59). Aldosterone did not correlate with HDL-C. Hyperaldosteronemia was a significant risk factor of high TC (odds ratio (OR) 4,44, 95% CI 1,97–10, for TC > 5 mmol/L, p < 0,001), LDL-C (OR 3,35, 95% CI 1,56 –7,21, for LDL-C > 3 mmol/L, p = 0,001) and TG (OR 3,04, 95% CI 1,43–6,90 for TG > 1,7 mmol/L, p = 0,006). TC, LDL-C and TG were significantly higher in obesity than in normal or overweight (p < 0,05). Significant changes in HDL-C depending on body mass index were not detected. Conclusions. In patients with HFpEF, aldosterone plasma level is closely related to TC, LDL-C and TG. Among hyperaldosteronic patients dyslipidemia is most severe in case of obesity.

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