Published online before print June 3, 2002, doi: 10.1161/01.HYP.0000023182.68420.EB
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(Hypertension. 2002;40:23.)
© 2002 American Heart Association, Inc.
Scientific Contributions |
Excess ldosterone Is Associated With Alterations of Myocardial Texture in Primary Aldosteronism
From the Cardiac and Thoracic Department, University of Pisa (V.D.B., A.B., D.G., M.M.); and the Department of Clinical and Experimental Medicine, University of Padua Medical School (G.P.R., C.G., A.S., M.C., R.S., A.C.P.), Italy.
Correspondence to Prof Gian Paolo Rossi, MD., F.A.C.C, F.A.H.A., Department of Clinical and Experimental Medicine, Clinica Medica 4, Policlinico Universitario, via Giustiniani, 2, 35126 Padova, Italy. E-mail gianpaolo.rossi{at}unipd.it
Hyperaldosteronism has been causally linked to myocardial interstitial fibrosis experimentally, but it remains unclear if this link also applies to humans. Thus, we investigated the effects of excess aldosterone due to primary aldosteronism (PA) on collagen deposition in the heart. We used echocardiography to estimate left ventricular (LV) wall thickness and dimensions and for videodensitometric analysis of myocardial texture in 17 consecutive patients with PA and 10 patients with primary (essential) hypertension who were matched for demographics, casual blood pressure, and known duration of hypertension. The groups differed in serum K+, ECG PQ interval duration, plasma renin activity, and aldosterone levels (all P
0.002) but not for casual blood pressure values, demographics, and duration of hypertension. Compared with hypertensive patients, PA patients showed a higher LV mass index (53.7±1.8 versus 45.5±2.0 g/m2.7; P=0.008) and lower values of the cyclic variation index of the myocardial mean gray level of septum (CVIs; -12.02±5.84% versus 6.06±3.08%; P=0.012) and posterior wall (-11.13±6.42% versus 8.63±9.62%; P=0.012). A regression analysis showed that CVIs was predicted by the PQ duration, supine plasma renin activity, plasma aldosterone, and age, which collectively accounted for 
36% of CVIs variance. PA is associated with alterations of myocardial textures that suggest increased collagen deposition and that can explain both the dependence of LV diastolic filling from presystole and the prolongation of the PQ interval.
Key Words: hypertension, endocrine • aldosterone • myocardial • hypertrophy • fibrosis • echocardiography
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