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.