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Cardiac aldosterone in subjects with hypertrophic cardiomyopathy

Wenxia Chai1, Yvonne Hoedemaekers, Ron H N van Schaik

  • 1Department of Pharmacology, Erasmus MC, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.

Journal of the Renin-Angiotensin-Aldosterone System : JRAAS
|February 24, 2007
PubMed

Insights

Aldosterone levels are normal in hypertrophic cardiomyopathy (HCM). However, a specific gene variant (CYP11B2 C-344T) is linked to increased heart muscle thickening in men with HCM, suggesting a potential therapeutic target.

Area of Science:

  • Cardiology
  • Genetics
  • Endocrinology

Background:

  • Left ventricular (LV) hypertrophy in hypertrophic cardiomyopathy (HCM) exhibits variability, indicating potential roles for modifying factors.
  • Aldosterone's influence on cardiac hypertrophy in HCM requires elucidation.

Purpose of the Study:

  • To investigate the role of aldosterone in modulating left ventricular hypertrophy in patients with HCM.
  • To examine the association between the aldosterone synthase (CYP11B2) C-344T polymorphism and cardiac hypertrophy in HCM.

Main Methods:

  • Measurement of cardiac and plasma aldosterone levels in organ donors and HCM patients.
  • Genotyping for the CYP11B2 C-344T polymorphism in 79 HCM subjects.
  • Analysis of LV mass index (LVMI) and interventricular septum thickness (IVS) in relation to genotype.

Main Results:

  • Cardiac and plasma aldosterone levels were comparable between HCM patients and normal controls.
  • In HCM men, the presence of the T allele of the CYP11B2 polymorphism was associated with increased LVMI and IVS.
  • These associations were independent of other key components of the renin-angiotensin system.

Conclusions:

  • Circulating and cardiac aldosterone levels are not selectively increased in HCM.
  • The observed association between the CYP11B2 C-344T polymorphism and hypertrophy in HCM is likely mediated by T allele-related increases in circulating aldosterone.
  • Further research is warranted to explore the potential benefits of aldosterone blockade in managing HCM-related hypertrophy.

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