Aldosterone production is activated in failing ventricle in humans

Background-Recent reports have indicated that aldosterone is produced in ex tra-adrenal tissues in animals. The present study was designed to examine w hether aldosterone is produced in human heart. Methods and Results-Plasma levels of aldosterone, BNP, and angiotensin-conv erting enzyme were measured in anterior interventricular vein (AIV), corona ry sinus (CS), and aortic root (Ao), respectively, in 20 patients with left ventricular systolic dysfunction (LVSD), 25 patients with LV diastolic dys function (LVDD), and 23 control subjects. Aldosterone levels were significa ntly higher in AIV and CS than Ao in LVSD (98+/-10 versus 72+/-9 pg/mL, P<0 .001, and 97+/-11 versus 72+/-9 pg/mL, P<0.001, respectively) and LVDD (87/-10 versus 71+/-9 pg/mL, P<0.01, and 84+/-10 versus 71+/-9 pg/mL, P<0.01, respectively) groups, but no differences were observed in levels for these sites in the control group. Levels of ACE activity and BNP also were higher in AIV than Ao in both LV dysfunction groups. The difference in aldosteron e levels between AIV and Ao and those in BNP and angiotensin-converting enz yme had a significant positive correlation with LVEDP and a significant neg ative correlation with LV ejection fraction in the LVSD group. Conclusions-Production of aldosterone, angiotensin-converting enzyme, and B NP are activated in failing human ventricle in proportion to severity.