{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1361981470112358912.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.1161/circulationaha.106.653964"}},{"identifier":{"@type":"URI","@value":"https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.106.653964"}}],"dc:title":[{"@value":"Complementary and Incremental Mortality Risk Prediction by Cortisol and Aldosterone in Chronic Heart Failure"}],"description":[{"type":"abstract","notation":[{"@value":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background—</jats:italic>\n                    </jats:bold>\n                    In patients with systolic heart failure, high levels of circulating aldosterone are associated with an adverse prognosis, and mineralocorticoid receptor blockade improves survival. The prognostic significance of cortisol that may also bind and activate the mineralocorticoid receptor in chronic heart failure is unknown.\n                  </jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods and Results—</jats:italic>\n                    </jats:bold>\n                    Serum levels of cortisol and aldosterone were quantified in a prospective cohort study of 294 consecutive patients with chronic heart failure [48% were in New York Heart Association functional class III or IV; 58% had systolic heart failure]. During a median follow-up of 803 days (interquartile range, 314 to 1098), 79 patients died (27.3% mortality rate). Cortisol and aldosterone were independent predictors of increased mortality risk in Cox regression analyses adjusted for age, sex, New York Heart Association functional class, C-reactive protein, N-terminal pro-brain natriuretic peptide, sodium, and hypercholesterolemia. The hazard ratio for highest versus lowest tertile of cortisol was 2.72 [95% confidence interval [CI], 1.38 to 5.36;\n                    <jats:italic>P</jats:italic>\n                    =0.004], and the hazard ratio for aldosterone was 2.19 (95% CI, 1.23 to 3.93;\n                    <jats:italic>P</jats:italic>\n                    =0.008). Patients with both cortisol and aldosterone levels above the respective medians had a 3.4-fold higher mortality risk compared with subjects with both corticosteroids below the median (95% CI, 1.54 to 7.46;\n                    <jats:italic>P</jats:italic>\n                    =0.0001). Addition of cortisol and aldosterone levels to the fully adjusted model significantly improved the discriminatory power [increase in Harrell’s\n                    <jats:italic>C</jats:italic>\n                    -statistic from 0.80 (95% CI, 0.70 to 0.90) to 0.86 (95% CI, 0.79 to 0.94;\n                    <jats:italic>P</jats:italic>\n                    <0.001 for change].\n                  </jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusions—</jats:italic>\n                    </jats:bold>\n                    In patients with chronic heart failure, higher serum levels of both cortisol and aldosterone were independent predictors of increased mortality risk that conferred complementary and incremental prognostic value.\n                  </jats:p>"}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1381981470112358784","@type":"Researcher","foaf:name":[{"@value":"Gülmisal Güder"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1381981470112358918","@type":"Researcher","foaf:name":[{"@value":"Johann Bauersachs"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1381981470112358912","@type":"Researcher","foaf:name":[{"@value":"Stefan Frantz"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1381981470112358915","@type":"Researcher","foaf:name":[{"@value":"Dirk Weismann"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1381981470112358916","@type":"Researcher","foaf:name":[{"@value":"Bruno Allolio"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1381981470112358913","@type":"Researcher","foaf:name":[{"@value":"Georg Ertl"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1381981470112358917","@type":"Researcher","foaf:name":[{"@value":"Christiane E. Angermann"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]},{"@id":"https://cir.nii.ac.jp/crid/1381981470112358914","@type":"Researcher","foaf:name":[{"@value":"Stefan Störk"}],"jpcoar:affiliationName":[{"@value":"From the Department of Internal Medicine I, Center for Cardiovascular Medicine, University of Würzburg, Würzburg, Germany."}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"00097322"},{"@type":"EISSN","@value":"15244539"}],"prism:publicationName":[{"@value":"Circulation"}],"dc:publisher":[{"@value":"Ovid Technologies (Wolters Kluwer Health)"}],"prism:publicationDate":"2007-04-03","prism:volume":"115","prism:number":"13","prism:startingPage":"1754","prism:endingPage":"1761"},"reviewed":"false","url":[{"@id":"https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.106.653964"}],"createdAt":"2007-03-19","modifiedAt":"2024-05-13","relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360002217755124096","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Beneficial Effects of Torasemide on Systolic Wall Stress and Sympathetic Nervous Activity in Asymptomatic or Mildly Symptomatic Patients With Heart Failure: Comparison With Azosemide"}]},{"@id":"https://cir.nii.ac.jp/crid/1360002218731276928","@type":"Article","resourceType":"学術雑誌論文(journal article)","relationType":["isReferencedBy"],"jpcoar:relatedTitle":[{"@value":"Oxidative Stress Causes Mineralocorticoid Receptor Activation in Rat 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