| Citation: |
YAO Zhi-feng, TANG Min-na, HU Jia-lu, et al. Correlation between hypothalamic-pituitary-adrenal axis rhythm changes and cardiac function in patients with chronic heart failure[J]. Chin J Clin Med, 2020, 27(1): 55-59. DOI: 10.12025/j.issn.1008-6358.2020.20191905
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To investigate the relationship between hypothalamic-pituitary-adrenal axis (HPA) rhythm changes and cardiac function in patients with chronic heart failure (CHF).
Consecutive 108 CHF patients (49 in the non-severe CHF group, 59 in the severe CHF group) and 43 non-CHF patients hospitalized in the same period were selected. The plasma levels of total bilirubin, albumin, creatinine, and N-terminal pro brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) were measured, and the glomerular filtration rate (GFR) was calculated. Plasma levels of adrenocorticotropic hormone (ACTH) and cortisol (COR) were measured at three time points of 0:00, 8:00, and 16:00 on the same day. Then the day and night COR ratio (RCOR8:00/COR0:00) and daytime COR ratio (RCOR8:00/COR16:00) were calculated. The differences of above indices among the three groups were compared.
Compared with non-CHF group, the plasma levels of ACTH at 0:00 and COR at 0:00 and 16:00 were significantly increased in CHF group, while RCOR8:00/COR0:00 and RCOR8:00/COR16:00 were significantly lower (P < 0.05). The COR level at 0:00, 8:00 and ACTH level at 0:00, 8:00, 16:00 in severe CHF group were all higher than those in non-severe CHF group and non-CHF group (P < 0.05). RCOR8:00/COR0:00 decreased in turn in the non-CHF group, non-severe CHF group, and severe CHF group (P < 0.05).
HPA axis is chronically and persistently activated in CHF patients, and COR can be used as an indicator to reflect the severity of CHF, and plasma COR level may be of high value for disease assessment and prognosis judgment.
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