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[Left ventricular myocardial structure and function in patients with primary aldosteronism]
Terapevticheskii Arkhiv
|December 20, 1999
Summary
Primary aldosteronism (PA) patients showed left ventricular hypertrophy (LVH) and impaired diastolic function. Surgery regressed LVH and improved function, but normalization was incomplete, suggesting persistent myocardial changes.
Area of Science:
- Cardiology
- Endocrinology
- Hypertension Research
Background:
- Primary aldosteronism (PA) is a significant cause of secondary hypertension.
- PA is associated with left ventricular hypertrophy (LVH) and diastolic dysfunction.
- Understanding the cardiac impact of PA and surgical outcomes is crucial.
Purpose of the Study:
- To assess left ventricular hypertrophy (LVH) and function in primary aldosteronism (PA) patients.
- To compare cardiac parameters in PA versus hyperaldosteronemia and hypertension.
- To track changes in LVH and function post-aldosteronoma removal.
Main Methods:
- Studied 28 PA patients (age 26-58) before and after aldosteronoma removal (1 month, 1 year, 2-5 years).
- Measured aldosterone (AC) and plasma renin activity (PRA).
- Assessed myocardial status using echocardiography and Doppler echocardiography; 30 healthy subjects as controls.
Main Results:
- All PA patients presented with initial to moderate LVH, influenced by diastolic pressure and PRA.
- Unilateral adrenalectomy led to decreased PRA and blood pressure within 1 month.
- LVH regression occurred 1 year post-surgery; diastolic function improved but did not normalize within 5 years.
Conclusions:
- Surgical removal of aldosteronoma regresses left ventricular hypertrophy (LVH).
- Diastolic function improves post-surgery but may not fully normalize, even years later.
- Persistent myocardial fibrosis and hyperaldosteronism effects may explain incomplete diastolic function recovery.