Relationship Between Urinary Angiotensinogen and Mortality in Patients with Heart Failure with Reduced Ejection Fraction

BACKGROUND

Activation of the reninangi otens in-aldosterone system has an important role in the pathophysiology of heart failure with reduced ejection fraction. While the effects of systemic reninangi otens in-aldosterone system activation on heart failure with reduced ejection fraction are well known, the impact of the local reninangi otens in-aldosterone system on heart failure with reduced ejection fraction is not fully understood because of limited clinical research. This study aimed to investigate the effect of urinary angiotensinogen level, an accepted indicator of local reninangi otens in-aldosterone system activation, on all-cause mortality in patients with heart failure with reduced ejection fraction.

METHODS

This retrospective, single-center study included 60 patients with baseline urinary angiotensinogen data and survival/mortality data at 4 years. Urinary angiotensinogen values were standardized to the urinary creatinine value measured from the same urine sample. The median urinary angio tensi nogen /urin ary creatinine value among all patients (114 μg/g) was used as a cutoff to divide the patients into 2 groups. Mortality data were obtained from the national registry systems or by telephone.

RESULTS

Comparison of all-cause mortality in the 2 groups showed that 22 deaths (71%) occurred in the group with a urinary angio tensinogen/urinary creatinine ratio above the median and 10 deaths (35.5%) occurred in the group of patients with urinary angio tensinogen/urinary creatinine equal to or below the median value (P =.005).

CONCLUSION

Our study suggests that urinary angiotensinogen can be used as a new biomarker in the prognosis and follow-up of heart failure patients.

The Role of Oxidative Stress and Inflammatory Mediators in Benign Paroxysmal Positional Vertigo

OBJECTIVE

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral cause of vertigo. It can be defined as transient vertigo induced by rapid changes in head position associated with a characteristic paroxysmal positional nystagmus. The aim of this study was to search for the possible role of oxidative stress and inflammatory mediators in the pathogenesis of BPPV.

MATERIALS AND METHODS

Total antioxidant status as well as paraoxonase, tumor necrosis factor alpha, interleukin (IL) 6, and IL-1β levels were evaluated in peripheral venous serum samples of 30 BPPV and 30 control patients.

RESULTS

Total antioxidant status levels were lower in the BPPV group than in the control group (p=0.008). After Epley's repositioning maneuver in the vertigo group, there was a statistically significant decline in IL-1β levels at the first and third month visits (p=0.014 for first month and p=0.013 for third month).

CONCLUSION

Our findings suggested that IL-1β and oxidative stress contributed to the pathogenesis of BPPV.