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Left ventricular systolic function in primary aldosteronism and hypertension
G P Rossi1, A Sacchetto, E Pavan
1Department of Clinical and Experimental Medicine, Clinica Medica 4, University of Padua Medical School and Azienda Ospedaliera di Padova, Italy. gprossi@ux1.unipd.it
Journal of Hypertension
|January 14, 1999
Summary
Primary aldosteronism (PA) does not enhance left-ventricular systolic function (LVSF) despite increased cardiac index. This study found no evidence of increased LV inotropism in PA patients under resting conditions.
Area of Science:
- Cardiology
- Endocrinology
- Physiology
Background:
- Primary aldosteronism (PA) is characterized by excess aldosterone, potentially affecting cardiac function.
- Left-ventricular systolic function (LVSF) is crucial for maintaining cardiac output.
- Investigating the inotropic effects of aldosterone on the left ventricle is important for understanding PA pathophysiology.
Purpose of the Study:
- To determine if excess aldosterone in primary aldosteronism (PA) influences left-ventricular systolic function (LVSF).
- To assess the potential positive inotropic effect of aldosterone on LVSF in PA patients.
- To compare cardiac function parameters between PA patients and essential hypertension (EH) patients.
Main Methods:
- Echocardiography (M-mode, 2D) and Doppler flow velocity measurements in 82 patients (44 PA, 38 EH).
- Measurement of left-ventricular (LV) midwall fractional shortening (MwFSho) and LV circumferential end-systolic stress (cESS).
- Analysis of the relationship between MwFSho and cESS to evaluate inotropic state.
Main Results:
- PA patients showed a significantly higher cardiac index (CI) compared to EH patients.
- LV diastolic filling in PA patients was characterized by a greater reliance on atrial contraction.
- No significant differences were observed in mean blood pressure, MwFSho, cESS, or the MwFSho-cESS relationship between PA and EH groups.
Conclusions:
- Primary aldosteronism is associated with a modest increase in cardiac index.
- LV diastolic filling patterns are altered in PA, with increased atrial contribution.
- The study does not support the hypothesis that excess aldosterone in PA enhances LV inotropism at rest.