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The Association between Glomerular Hyperfiltration and Left Ventricular Structure and Function in Patients with
Min-Tsun Liao1, Xue-Ming Wu2, Chin-Chen Chang3
11. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan;
International Journal of Medical Sciences
|May 26, 2015
Summary
Primary aldosteronism (PA) patients with glomerular hyperfiltration show increased left ventricular mass and altered diastolic function. This may be due to higher intravascular volume in these patients.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Glomerular hyperfiltration is increasingly recognized in primary aldosteronism (PA).
- The cardiovascular implications of hyperfiltration in PA remain unclear.
Purpose of the Study:
- To investigate the cardiovascular effects of glomerular hyperfiltration in PA patients.
- To compare cardiac structure and function in PA patients with and without hyperfiltration.
Main Methods:
- Prospective analysis of 47 PA patients categorized by estimated glomerular filtration rate (eGFR): hyperfiltration (>130 ml/min/1.73 m2) vs. normal (90-110 ml/min/1.73 m2).
- 14 essential hypertension (EH) patients with normal eGFR served as controls.
- Echocardiography, including left ventricular mass index (LVMI) and tissue Doppler imaging (TDI), was used to assess cardiac parameters.
Main Results:
- LVMI and E/E' ratio decreased significantly from the hyperfiltration PA group to the normal eGFR PA group and controls.
- PA patients with normal eGFR exhibited a higher percentage of inappropriate left ventricular mass (LVM) than controls.
- PA patients with hyperfiltration had higher mitral E velocity and E/A ratio compared to PA patients with normal eGFR.
Conclusions:
- PA patients with glomerular hyperfiltration present with increased LVMI and altered diastolic function (higher mitral E velocity, E/E' ratio).
- Despite hyperfiltration, these patients had comparable E' values to PA patients with normal GFR.
- Elevated intravascular volume may explain these cardiovascular findings in PA patients with hyperfiltration.
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