Excess ldosterone Is Associated With Alterations of Myocardial Texture in Primary Aldosteronism

G. Rossi, V. Di Bello, C. Ganzaroli, A. Sacchetto, M. Cesari, A. Bertini, D. Giorgi, R. Scognamiglio, M. Mariani, A. Pessina
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引用次数: 228

Abstract

Hyperaldosteronism has been causally linked to myocardial interstitial fibrosis experimentally, but it remains unclear if this link also applies to humans. Thus, we investigated the effects of excess aldosterone due to primary aldosteronism (PA) on collagen deposition in the heart. We used echocardiography to estimate left ventricular (LV) wall thickness and dimensions and for videodensitometric analysis of myocardial texture in 17 consecutive patients with PA and 10 patients with primary (essential) hypertension who were matched for demographics, casual blood pressure, and known duration of hypertension. The groups differed in serum K+, ECG PQ interval duration, plasma renin activity, and aldosterone levels (all P ≤0.002) but not for casual blood pressure values, demographics, and duration of hypertension. Compared with hypertensive patients, PA patients showed a higher LV mass index (53.7±1.8 versus 45.5±2.0 g/m2.7;P =0.008) and lower values of the cyclic variation index of the myocardial mean gray level of septum (CVIs; −12.02±5.84% versus 6.06±3.08%;P =0.012) and posterior wall (−11.13±6.42% versus 8.63±9.62%;P =0.012). A regression analysis showed that CVIs was predicted by the PQ duration, supine plasma renin activity, plasma aldosterone, and age, which collectively accounted for ≈36% of CVIs variance. PA is associated with alterations of myocardial textures that suggest increased collagen deposition and that can explain both the dependence of LV diastolic filling from presystole and the prolongation of the PQ interval.
原发性醛固酮增多症中过量的醛固酮与心肌结构改变有关
实验表明,高醛固酮增多症与心肌间质纤维化有因果关系,但尚不清楚这种联系是否也适用于人类。因此,我们研究了原发性醛固酮增多症(PA)引起的过量醛固酮对心脏胶原沉积的影响。我们使用超声心动图估计左心室(LV)壁厚度和尺寸,并对17例连续的PA患者和10例原发性(原发性)高血压患者的心肌质地进行视频密度分析,这些患者在人口统计学、随意血压和已知高血压持续时间方面相匹配。两组在血清K+、心电图PQ间隔时间、血浆肾素活性和醛固酮水平方面存在差异(P均≤0.002),但在随意血压值、人口统计学和高血压持续时间方面没有差异。与高血压患者相比,PA患者的左室质量指数(53.7±1.8)高于高血压患者(45.5±2.0 g/m2.7, P =0.008),心肌间隔平均灰度循环变异指数(CVIs;- 12.02±5.84%比6.06±3.08%,P =0.012)和后壁(- 11.13±6.42%比8.63±9.62%,P =0.012)。回归分析显示,PQ持续时间、仰卧位血浆肾素活性、血浆醛固酮和年龄可以预测CVIs,这些因素合计占CVIs方差的约36%。PA与心肌结构改变有关,表明胶原沉积增加,这可以解释左室舒张充盈依赖于收缩前和PQ间期延长。
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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