This Article Full Text Full Text (PDF) CME: Take the course for this article: Hypertension: September 2008,Volume 52, Number 3 Data Supplement All Versions of this Article: 52/3/529    most recent HYPERTENSIONAHA.108.114140v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Muiesan, M. L. Articles by Agabiti-Rosei, E. Search for Related Content PubMed PubMed Citation Articles by Muiesan, M. L. Articles by Agabiti-Rosei, E. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information High Blood Pressure Related Collections Other hypertension Hypertrophy Echocardiography

(Hypertension. 2008;52:529.)
© 2008 American Heart Association, Inc.

Original Articles

Inappropriate Left Ventricular Mass in Patients With Primary Aldosteronism

Maria Lorenza Muiesan; Massimo Salvetti; Anna Paini; Claudia Agabiti-Rosei; Cristina Monteduro; Gloria Galbassini; Eugenia Belotti; Carlo Aggiusti; Damiano Rizzoni; Maurizio Castellano; Enrico Agabiti-Rosei

From the Clinica Medica, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.

Correspondence to Maria Lorenza Muiesan, Clinica Medica, Department of Medical and Surgical Sciences, University of Brescia, 25100 Brescia, Italy. E-mail muiesan{at}med.unibs.it

Assessment of appropriateness of left ventricular mass (LVM) for a given workload may better stratify hypertensive patients. Inappropriate LVM may reflect the interaction of genetic and neurohumoral factors other than blood pressure playing a significant role in myocardial growth. Primary aldosteronism (PA) represents a clinical model useful in assessing the effect of aldosterone increase on LVM. The aim of this study was to evaluate the inappropriateness of LVM in patients with PA. In 125 patients with PA (54 females; adrenal hyperplasia in 73 and adenoma in 52 patients) and in 125 age-, sex-, and blood pressure–matched, essential hypertensive patients, echocardiography was performed. The appropriateness of LVM was calculated by the ratio of observed LVM to the predicted value using a reference equation. In all of the subjects plasma renin activity and aldosterone, as well as clinic and 24-hour blood pressure, were measured. The prevalence of inappropriate LVM was greater in patients with traditionally defined left ventricular hypertrophy (70% and 44%, respectively; P=0.02) but also in patients without left ventricular hypertrophy (17% and 9%, respectively; P=0.085). In PA patients, a correlation was observed between the ratio of observed:predicted LVM and the ratio of aldosterone:plasma renin activity levels (r=0.29; P=0.003) or the postinfusion aldosterone concentration (r=0.44; P=0.004; n=42). In conclusion, in patients with PA, the prevalence of inappropriate LVM is increased, even in the absence of traditionally defined left ventricular hypertrophy. The increase in aldosterone levels could contribute to the increase of LV mass exceeding the amount needed to compensate hemodynamic load.

Key Words: hypertension arterial • hypertrophy • echocardiography • aldosterone • inappropriate LV mass

This article has been cited by other articles:

				J. Diez Effects of Aldosterone on the Heart: Beyond Systemic Hemodynamics? Hypertension, September 1, 2008; 52(3): 462 - 464. [Full Text] [PDF]