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A probable relationship between an endogenous digitalis-like substance and concentric cardiac hypertrophy in primary
T Shimada1, Y Nagasaka, Y Ishibashi
1Department of Internal Medicine, Shimane Medical University, Izumo.
Insights
This study links elevated endogenous digitalis-like substance (EDLS) to cardiac hypertrophy in primary aldosteronism. Tumor removal normalized EDLS and reversed heart enlargement, suggesting EDLS involvement in this condition.
Area of Science:
- Cardiology
- Endocrinology
- Nephrology
Background:
- Primary aldosteronism is a condition characterized by excessive aldosterone production.
- Hypertension and cardiac hypertrophy are common complications.
Observation:
- A patient with severe hypertension and left ventricular hypertrophy had an adrenal mass.
- Elevated plasma aldosterone and endogenous digitalis-like substance (EDLS) levels were noted.
- EDLS normalized post-adrenal tumor removal.
Findings:
- The study observed a direct correlation between elevated EDLS and cardiac hypertrophy.
- Regression of cardiac hypertrophy was documented over six years post-surgery.
- These findings suggest EDLS plays a role in the development of cardiac hypertrophy in primary aldosteronism.
Implications:
- This research highlights the potential role of EDLS in aldosterone-induced cardiac remodeling.
- Understanding this link may lead to novel therapeutic targets for hypertension-related heart disease.
- Further investigation into EDLS mechanisms is warranted.
Abstract:
A 44-year-old woman was admitted to our hospital due to severe hypertension. An electrocardiogram (ECG) and an echocardiogram showed severe left ventricular hypertrophy. Her plasma aldosterone level was elevated. Magnetic resonance imaging revealed a small mass in the right adrenal gland. Before removal of the tumor, plasma endogenous digitalis-like substance (EDLS) levels were elevated. After removal of the tumor, EDLS levels quickly returned to the normal level. A series of echocardiograms and ECGs over a 6- year period after removal of the tumor showed marked regression of cardiac hypertrophy. These findings suggest that EDLS may be closely related to the development of concentric cardiac hypertrophy in primary aldosteronism.