ASSOCIATION OF BETA-ADRENOREACTIVITY OF ERYTHROCYTE MEMBRANES WITH THE SEVERITY OF CHRONIC HEART FAILURE IN PATIENTS WITH CORONARY HEART DISEASE

Highlights Beta-adrenoreactivity of erythrocyte membranes (beta-ARM) is an indirect indicator of the activity of the sympathoadrenal system and can act as a marker of the severity of heart failure. In patients with chronic coronary artery disease, higher beta-ARM values are associated with a lower left ventricular ejection fraction. Beta-ARM is elevated in people who have suffered a prior myocardial infarction. Abstract Aim . To assess the relationship between erythrocyte membrane beta-adrenoreactivity (beta-ARM) and the level of catecholamines in the blood with the functional state of the myocardium in patients with chronic heart failure (CHF) of ischemic origin. Methods . The study included 116 patients with chronic ischemic heart disease, of which 56.9% of patients had postinfarction cardiosclerosis (PICS). In the sample, functional class (FC) I CHF was present in 10.3% of patients, FC II in 56.0% of patients, and FC III in 33.6% of patients. Based on echocardiography data, CHF with preserved left ventricular ejection fraction (LVEF≥50%) was detected in 78.4% of patients, in 7.8% of patients with reduced LVEF<40%, and in 13.8% of patients with mid‐range LVEF 40–49%. The levels of adrenaline and norepinephrine in the blood plasma were determined using the ELISA kits. Beta-ARM was assessed using the Beta-ARM-Agate kit in accordance with the manufacturer's protocol. Results . The study sample revealed an inverse relationship between beta-ARM and LVEF (r = –0.318, p = 0.001), as well as a direct correlation with the LV sphericity index (r = 0.331, p = 0.001). An inverse linear relationship was found between the LVEF and the level of adrenaline (r = –0.287, p = 0.010) and norepinephrine (r = –0.418, p < 0.001). Patients with PICS had higher values of beta-ARM (29.7% (19.2; 39.1) vs 21.4% (14.8; 26.7), p = 0.004) and norepinephrine (30.5% (24.3; 41.8) vs 26.9% (19.6; 30.1), p = 0.042) compared with patients without PICS. Groups with different CHF FCs had comparable levels of catecholamines, but differed in beta-ARM (p = 0.029): 22.8% (19.5; 29.2) with FC I, 21.4% (14.8; 28.4) with FC II, 30.1% (19.4; 40.1) with FC III. There was a tendency towards differences in beta-ARM between groups in LVEF (p = 0.053). Conclusion . Thus, the results of the study revealed an association between beta-ARM and norepinephrine levels with systolic myocardial dysfunction. Higher values of beta-ARM and norepinephrine correlate with lower LVEF and indicate an unfavorable course of heart failure.