The mTOR-inhibitor everolimus reduces hypervolemia in patients with primary aldosteronism.

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM
Minerva endocrinology Pub Date : 2024-06-01 Epub Date: 2021-04-01 DOI:10.23736/S2724-6507.21.03382-0
Beckey Trinh, Thilo Burkard
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引用次数: 0

Abstract

Background: We recently showed in a proof-of-concept study that treating individuals with primary aldosteronism with the mTOR-inhibitor everolimus decreases home blood pressure and renin suppression overall, and markedly reduces aldosterone levels in a subset of individuals. Based on these findings, the question arose whether the effects of everolimus were also mediated via aldosterone-independent mechanisms. Here, we undertook an exploratory, secondary analysis of above-mentioned study to comprehensively investigate how everolimus impacted the hemodynamic status of the study participants, which in turn could elucidate these mechanisms.

Methods: Hemodynamic parameters were measured in study participants with primary aldosteronism at baseline, after treatment with everolimus 0.75 mg orally twice daily for 2 weeks and after a 2-week wash-out. Of the 14 participants, 10 participants had complete data sets for peripheral and central blood pressure, heart rate and pulse wave velocity, and 7 participants had complete data sets for cardiac index, inotropic state index, left stroke work index and stroke systemic vascular resistance index that could be analyzed. Parameters were acquired by brachial oscillometry (Mobil-o-graph PWA) and thoracic electrical bioimpedance (HOTMAN® System).

Results: After treatment with everolimus, peripheral (P=0.049) and central (P=0.037) diastolic blood pressure, as well as hypervolemia (P=0.008) were significantly decreased. Likewise, peripheral (P=0.073) and central systolic blood pressure (P=0.166) trended downwards.

Conclusions: Everolimus lowers central and peripheral blood pressure in individuals with primary aldosteronism, possibly by decreasing primary aldosteronism-induced hypervolemia and preload.

mTOR抑制剂依维莫司可降低原发性醛固酮增多症患者的高血容量。
研究背景我们最近在一项概念验证研究中发现,用mTOR抑制剂依维莫司治疗原发性醛固酮增多症患者可降低家庭血压和肾素抑制,并显著降低部分患者的醛固酮水平。基于这些发现,我们提出了依维莫司的作用是否也通过醛固酮依赖机制介导的问题。在此,我们对上述研究进行了探索性的二次分析,以全面研究依维莫司如何影响研究参与者的血液动力学状态,进而阐明这些机制。方法:测量原发性醛固酮增多症研究参与者在基线、依维莫司 0.75 毫克口服治疗 2 周(每天两次)和 2 周停药后的血液动力学参数。在 14 名参与者中,10 名参与者有完整的外周和中心血压、心率和脉搏波速度数据集,7 名参与者有完整的心脏指数、肌力状态指数、左搏功指数和搏动系统血管阻力指数数据集,可以进行分析。参数通过肱骨震荡仪(Mobil-o-graph PWA)和胸廓生物电阻抗仪(HOTMAN® 系统)获得:结果:使用依维莫司治疗后,外周(p = 0.049)和中心(p = 0.037)舒张压以及高血容量(p = 0.008)显著下降。同样,外周(p = 0.073)和中心收缩压(p = 0.166)也呈下降趋势:结论:依维莫司可降低原发性醛固酮增多症患者的中心血压和外周血压,可能是通过降低原发性醛固酮增多症引起的高血容量和前负荷。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
146
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