Related Experiment Video
Updated: Feb 27, 2026
Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Aldosterone and renin in cardiac patients referred for catheterization
Paul Erne1, Andrea Müller, Gian Paolo Rossi
1Laboratory of Signal Transduction, Department of Biomedicine, University Hospital Basel, Hebelstrasse, Basel Department of Cardiology, Luzerner Kantonsspital, Spitalstrasse, Luzern Clinica dell'Ipertensione Arteriosa, Department of Medicine, University Hospital of Padua, Padua, Italy Division of Biostatistics, University of Zurich, EBPI, Hirschengraben, Zürich Institute Viollier, Hagmattstrasse, Allschwil, Switzerland Inovise Medical, Inc., Creekside Corporate Park, Nimbus Ave D, Beaverton, OR AMIS Plus Data Center, University of Zurich, EBPI, Hirschengraben, Zurich, Switzerland.
Insights
Alterations in the renin-angiotensin system are common in cardiac patients. Elevated plasma renin was linked to hypertension, coronary artery disease, and impaired ejection fraction in patients undergoing cardiac catheterization.
Area of Science:
- Cardiology
- Endocrinology
- Renal Physiology
Background:
- The renin-angiotensin system (RAS) plays a crucial role in cardiovascular homeostasis.
- Alterations in RAS components are implicated in various cardiovascular diseases.
- Limited data exists on RAS component levels in patients undergoing cardiac catheterization.
Purpose of the Study:
- To determine the prevalence of elevated plasma active renin, aldosterone, and the aldosterone-renin ratio (ARR) in patients referred for cardiac catheterization.
- To investigate the association of these hormonal elevations with common cardiac conditions.
Main Methods:
- A prospective study involving 833 consecutive patients undergoing cardiac catheterization.
- Plasma aldosterone concentration (PAC) and active renin levels were measured using a chemiluminescence assay.
- Hormonal levels were analyzed in relation to hypertension, atrial fibrillation (AF), hypertensive cardiomyopathy, coronary artery disease (CAD), valvular disease, impaired left ventricular ejection fraction (LVEF < 35%), and pulmonary hypertension.
Main Results:
- Hyperaldosteronism was observed in approximately one-third of patients, with no significant difference based on cardiac disease presence.
- Elevated plasma renin was significantly more frequent in patients with hypertension (36.4%), CAD (33.9%), and impaired LVEF (47.3%) compared to those without these conditions.
- The ARR was elevated in patients with AF and hypertensive cardiomyopathy. Elevated renin was more common in AF patients with coexisting hypertension and in those with persistent/permanent AF compared to paroxysmal AF.
Conclusions:
- Distinct cardiac disease-associated differences exist in the prevalence of elevated plasma renin, PAC, and ARR in patients referred for cardiac catheterization.
- These findings highlight the potential role of RAS dysregulation in the pathophysiology of various cardiac conditions.
- Further research is warranted to explore the clinical implications and therapeutic targets related to RAS alterations in this patient population.
Abstract:
Little is known regarding alterations of the renin-angiotensin system in patients referred for cardiac catheterization. Here, we measured plasma levels of active renin and aldosterone in patients referred for cardiac catheterization in order to determine the prevalence of elevated renin, aldosterone, and the aldosterone-renin ratio.A chemiluminescence assay was used to measure plasma aldosterone concentration (PAC) and active renin levels in 833 consecutive patients, after an overnight fasting and without any medication for least 12 hours. We evaluated associations of the hormonal elevations in relation to hypertension, atrial fibrillation (AF), hypertensive cardiomyopathy, coronary artery disease (CAD), valvular disease, impaired left ventricular ejection fraction (LVEF < 35%), and pulmonary hypertension (arterial pulmonary mean pressure >25 mm Hg).Hyperaldosteronism occurred in around one-third of all examined patients, without significant differences between patients with or without the named cardiac diseases. In a comparison between patients with or without any given cardiac disease condition, renin was significantly elevated in patients with either hypertension (36.4% vs 15.9%), CAD (33.9% vs 22.1%), or impaired LVEF (47.3% vs 24.8%). The angiotensin-renin ratio was elevated in AF patients and in patients with hypertensive cardiomyopathy. Patients with AF and coexisting hypertension had elevated renin more frequently than AF patients without coexisting hypertension (35.3% vs 16.5%; P = .005). Patients with persistent/permanent AF more frequently had elevated renin than patients with paroxysmal AF (34.1% vs 15.8%; P = .007).This prospective study of consecutive cardiac disease patients referred for cardiac catheterization has revealed distinct cardiac disease condition-associated differences in the frequencies of elevations in plasma renin, PAC, and the aldosterone-renin ratio.
Related Concept Videos
01:33Hormonal Regulation
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:25Antihypertensive Drugs: Direct Renin Inhibitors
01:26Cardiac Catheterization IV: Nursing Management
01:26Regulation of Sodium and Potassium
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...