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Regression of electrocardiographic left ventricular hypertrophy following treatment of primary hyperaldosteronism
S D Pringle1, P W Macfarlane, C G Isles
1Department of Medical Cardiology, Royal Infirmary, Glasgow, UK.
Insights
Treatment for primary hyperaldosteronism (PHA) significantly reduces blood pressure and improves electrocardiogram (ECG) indicators of left ventricular hypertrophy (LVH), regardless of therapy type.
Area of Science:
- Cardiology
- Endocrinology
Background:
- Primary hyperaldosteronism (PHA) is associated with left ventricular hypertrophy (LVH) and cardiovascular complications.
- Electrocardiogram (ECG) changes are commonly observed in patients with PHA.
Purpose of the Study:
- To investigate the impact of PHA treatment on ECG-detected LVH.
- To compare the effectiveness of medical versus surgical treatment for PHA in improving ECG findings.
Main Methods:
- Analysis of ECGs from 34 PHA patients (17 surgical, 9 medical, 8 combined therapy).
- Assessment of blood pressure and ECG parameters (precordial voltages, LVH prevalence) before and after treatment.
Main Results:
- Significant blood pressure reduction observed across all treatment groups (P < 0.001).
- Reduction in precordial voltages (SV1 + RV5) from 3.68 mV to 2.79 mV (P < 0.01).
- Decrease in the number of patients with ECG-LVH from 15 to 8 (P < 0.05).
Conclusions:
- Treatment of PHA leads to significant improvements in blood pressure.
- Therapeutic interventions for PHA effectively reduce ECG signs of LVH.
- The observed improvements in ECG parameters are independent of the treatment modality (medical vs. surgical).
Abstract:
The electrocardiograms (ECGs) of a series of 34 patients with primary hyperaldosteronism (PHA), 17 treated surgically (group I) nine treated medically (group II) and eight treated with/by both surgery and drug therapy (group III) were analysed to determine whether the treatment of PHA resulted in an improvement in the ECG changes of left ventricular hypertrophy (LVH) and also whether there was a difference in this improvement between medically and surgically treated patients. There was a significant reduction of blood pressure in the group as a whole (186/111 to 141/95 mmHg, P less than 0.001) and within each of the treatment groups (group I 183/108 to 137/98 mmHg, group II 188/112 to 147/93 mmHg, group III 193/115 to 144/92 mmHg). This reduction within each group was of a similar magnitude. There were reductions in both precordial voltages (SV1 + RV5) from 3.68 mV to 2.79 mV (P less than 0.01) and in the number of patients with ECG LVH from 15 to 8 (P less than 0.05). Again the reductions were of similar magnitude in each of the groups: group I 3.78 to 2.77 mV, group II 3.78 to 2.84 mV, group III 3.39 to 2.77 mV. Thus the improvement in blood pressure achieved by the treatment of PHA is accompanied by a reduction in precordial voltages and the number of patients with ECG-LVH. This improvement is independent of the type of treatment used.