KCNJ5 Somatic Mutations in Aldosterone-Producing Adenoma Are Associated with a Greater Recovery of Arterial Stiffness

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Genetics

Background:

• Primary aldosteronism is a common cause of secondary hypertension, leading to cardiovascular damage.
• The specific impact of KCNJ5 somatic mutations in aldosterone-producing adenoma (APA) on arterial stiffness remains unclear, especially when controlling for confounding factors.

Purpose of the Study:

• To investigate the effect of KCNJ5 somatic mutations on arterial stiffness in patients with APA before and after adrenalectomy.
• To assess the correlation between KCNJ5 mutations and changes in arterial stiffness (baPWV) post-surgery.

Main Methods:

• 213 APA patients undergoing adrenalectomy were included.
• KCNJ5 gene sequencing was performed on APA tissue.
• Propensity score matching (PSM) was used to create comparable groups with and without KCNJ5 mutations (n=66 each).
• Brachial-ankle pulse wave velocity (baPWV) was measured to assess arterial stiffness.

Main Results:

• Before PSM, KCNJ5 mutation carriers had higher aldosterone levels and lower baseline baPWV. After PSM, no difference in baseline baPWV was observed.
• One year post-adrenalectomy, KCNJ5 mutation carriers showed significantly greater reductions in aldosterone, aldosterone-renin activity ratio, and baPWV compared to non-carriers.
• KCNJ5 mutations were not correlated with baseline baPWV but were significantly correlated with the change in baPWV (∆baPWV) after surgery.

Conclusions:

• APA patients with KCNJ5 mutations experience a more significant regression of arterial stiffness after adrenalectomy.
• KCNJ5 mutations are associated with improved arterial stiffness outcomes following surgical treatment for APA.