Published online before print June 3, 2002, doi: 10.1161/01.HYP.0000023182.68420.EB
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(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
This article has been cited by other articles:
 |
|
 |
|
  J. Peters, T. Schluter, T. Riegel, B. S. Peters, A. Beineke, U. Maschke, N. Hosten, J. J. Mullins, and R. Rettig Lack of cardiac fibrosis in a new model of high prorenin hyperaldosteronism Am J Physiol Heart Circ Physiol, November 1, 2009; 297(5): H1845 - H1852. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Martin-Fernandez, M.ķa Miana, N. De las Heras, G. Ruiz-Hurtado, M.ķa Fernandez-Velasco, M. Bas, S. Ballesteros, V. Lahera, V. Cachofeiro, and C. Delgado Cardiac L-type calcium current is increased in a model of hyperaldosteronism in the rat Exp Physiol, June 1, 2009; 94(6): 675 - 683. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Giacchetti, V. Ronconi, S. Rilli, M. Guerrieri, F. Turchi, and M. Boscaro Small tumor size as favorable prognostic factor after adrenalectomy in Conn's adenoma Eur. J. Endocrinol., April 1, 2009; 160(4): 639 - 646. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Lopez-Andres, C. Inigo, I. Gallego, J. Diez, and M. A. Fortuno Aldosterone Induces Cardiotrophin-1 Expression in HL-1 Adult Cardiomyocytes Endocrinology, October 1, 2008; 149(10): 4970 - 4978. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Muiesan, M. Salvetti, A. Paini, C. Agabiti-Rosei, C. Monteduro, G. Galbassini, E. Belotti, C. Aggiusti, D. Rizzoni, M. Castellano, et al. Inappropriate Left Ventricular Mass in Patients With Primary Aldosteronism Hypertension, September 1, 2008; 52(3): 529 - 534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. P. Gomez-Sanchez, D. G. Romero, A. F. de Rodriguez, M. P. Warden, Z. Krozowski, and C. E. Gomez-Sanchez Hexose-6-Phosphate Dehydrogenase and 11{beta}-Hydroxysteroid Dehydrogenase-1 Tissue Distribution in the Rat Endocrinology, February 1, 2008; 149(2): 525 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. J. Brown Aldosterone and Vascular Inflammation Hypertension, February 1, 2008; 51(2): 161 - 167. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Catena, G. Colussi, E. Nadalini, A. Chiuch, S. Baroselli, R. Lapenna, and L. A. Sechi Cardiovascular Outcomes in Patients With Primary Aldosteronism After Treatment Arch Intern Med, January 14, 2008; 168(1): 80 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Agabiti-Rosei, M. L. Muiesan, and M. Salvetti Review: New approaches to the assessment of left ventricular hypertrophy Therapeutic Advances in Cardiovascular Disease, December 1, 2007; 1(2): 119 - 128. [Abstract] [PDF]
|
|
|
|
|
|
C. Catena, G. Colussi, R. Lapenna, E. Nadalini, A. Chiuch, P. Gianfagna, and L. A. Sechi Long-Term Cardiac Effects of Adrenalectomy or Mineralocorticoid Antagonists in Patients With Primary Aldosteronism Hypertension, November 1, 2007; 50(5): 911 - 918. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Cooper, A. Whaley-Connell, J. Habibi, Y. Wei, G. Lastra, C. Manrique, S. Stas, and J. R. Sowers Renin-angiotensin-aldosterone system and oxidative stress in cardiovascular insulin resistance Am J Physiol Heart Circ Physiol, October 1, 2007; 293(4): H2009 - H2023. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Stas, A. Whaley-Connell, J. Habibi, L. Appesh, M. R. Hayden, P. R. Karuparthi, M. Qazi, E. M. Morris, S. A. Cooper, C. D. Link, et al. Mineralocorticoid Receptor Blockade Attenuates Chronic Overexpression of the Renin-Angiotensin-Aldosterone System Stimulation of Reduced Nicotinamide Adenine Dinucleotide Phosphate Oxidase and Cardiac Remodeling Endocrinology, August 1, 2007; 148(8): 3773 - 3780. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Auchus, D. W. Chandler, S. Singeetham, N. Chokshi, F. E. Nwariaku, B. L. Dolmatch, S. A. Holt, F. H. Wians Jr., S. C. Josephs, C. K. Trimmer, et al. Measurement of 18-Hydroxycorticosterone during Adrenal Vein Sampling for Primary Aldosteronism J. Clin. Endocrinol. Metab., July 1, 2007; 92(7): 2648 - 2651. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rahman, A. Nishiyama, P. Guo, Y. Nagai, G.-X. Zhang, Y. Fujisawa, Y.-Y. Fan, S. Kimura, N. Hosomi, K. Omori, et al. Effects of Adrenomedullin on Cardiac Oxidative Stress and Collagen Accumulation in Aldosterone-Dependent Malignant Hypertensive Rats J. Pharmacol. Exp. Ther., September 1, 2006; 318(3): 1323 - 1329. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Turchin, C. Z. Guo, G. K. Adler, V. Ricchiuti, I. S. Kohane, and G. H. Williams Effect of Acute Aldosterone Administration on Gene Expression Profile in the Heart Endocrinology, July 1, 2006; 147(7): 3183 - 3189. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Milliez, X. Girerd, P.-F. Plouin, J. Blacher, M. E. Safar, and J.-J. Mourad Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism J. Am. Coll. Cardiol., April 19, 2005; 45(8): 1243 - 1248. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Glorioso, F. Filigheddu, P. P. Parpaglia, A. Soro, C. Troffa, G. Argiolas, and P. Mulatero 11{beta}-Hydroxysteroid dehydrogenase type 2 activity is associated with left ventricular mass in essential hypertension Eur. Heart J., March 1, 2005; 26(5): 498 - 504. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D. Struthers The clinical implications of aldosterone escape in congestive heart failure Eur J Heart Fail, August 1, 2004; 6(5): 539 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Vasan, J. C. Evans, E. J. Benjamin, D. Levy, M. G. Larson, J. Sundstrom, J. M. Murabito, F. Sam, W. S. Colucci, and P. W. F. Wilson Relations of Serum Aldosterone to Cardiac Structure: Gender-Related Differences in the Framingham Heart Study Hypertension, May 1, 2004; 43(5): 957 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Q. Pu, M. F. Neves, A. Virdis, R. M. Touyz, and E. L. Schiffrin Endothelin Antagonism on Aldosterone-Induced Oxidative Stress and Vascular Remodeling Hypertension, July 1, 2003; 42(1): 49 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kozakova, S. Buralli, C. Palombo, G. Bernini, A. Moretti, S. Favilla, S. Taddei, and A. Salvetti Myocardial Ultrasonic Backscatter in Hypertension: Relation to Aldosterone and Endothelin Hypertension, February 1, 2003; 41(2): 230 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M MacKenzie, R. Fraser, J. M. Connell, and E. Davies Local renin-angiotensin systems and their interactions with extra-adrenal corticosteroid production Journal of Renin-Angiotensin-Aldosterone System, December 1, 2002; 3(4): 214 - 221. [Abstract] [PDF]
|
|