Vol 8, No 2 (2004)
Original paper
Published online: 2004-04-06
Left ventricular mass in patients with primary aldosteronism after etiologic treatment
Nadciśnienie tętnicze 2004;8(2):89-95.
Abstract
Background Primary aldosteronism is an example of common influence of humoral factors like aldosterone, adrenaline, dopamine and hemodynamic factors - volume
dependency and vascular resistance - on the left ventricular mass. The aim of the study was the assessment of left ventricular mass regression in patients with APA and IHA after operation and spironolactone treatment in follow up period from 6 to 12 mth’s.
Material and methods The study included 46 pts. with primary aldosteronism: 32 pts. with APA (28 F, 4 M with mean age 48,6 ± 4,1 yrs.) and 14 pts. with IHA (13 F, 1 M with mean age 48,5 ± 6,5 yrs.).
Blood pressure was determined by 24-hour monitoring, echocardiographic parameters were measured according to ASE. Aldosterone plasma concentration and plasma renin activity were determinated by radioimmunologic methods.
Results We observed statistically significant decrease of LVMI in both groups of pts. In IHA left ventricular hypertrophy (LVH) regression (124,76 ± 33,4 g/m2 vs. 106,10 ± 31,5 g/m2) resulted from decreased left ventricular wall thickness, with no changes in left ventricular diastolic dimension. Of note there were no significant changes in mean diastolic and systolic blood pressure. In APA pts. LVH regression (125 ± 25 /m2 vs. 98 ± 24 g/m2) was a consequence of decreased wall thickness and left ventricular diameter. In this group we observed statistically significant decrease of mean systolic blood pressure.
Conclusion 1. Left ventricular mass regression was observed both in pts. with APA and IHA after medical or surgical treatment. 2. Left ventricular mass regression in pts. with IHA without concomitant significant hypotensive effect suggests aldosterone influence on LVH. 3. Adrenalectomy in pts., with APA leads to more effective blood pressure lowering than spironolactone therapy in pts. with IHA.
Material and methods The study included 46 pts. with primary aldosteronism: 32 pts. with APA (28 F, 4 M with mean age 48,6 ± 4,1 yrs.) and 14 pts. with IHA (13 F, 1 M with mean age 48,5 ± 6,5 yrs.).
Blood pressure was determined by 24-hour monitoring, echocardiographic parameters were measured according to ASE. Aldosterone plasma concentration and plasma renin activity were determinated by radioimmunologic methods.
Results We observed statistically significant decrease of LVMI in both groups of pts. In IHA left ventricular hypertrophy (LVH) regression (124,76 ± 33,4 g/m2 vs. 106,10 ± 31,5 g/m2) resulted from decreased left ventricular wall thickness, with no changes in left ventricular diastolic dimension. Of note there were no significant changes in mean diastolic and systolic blood pressure. In APA pts. LVH regression (125 ± 25 /m2 vs. 98 ± 24 g/m2) was a consequence of decreased wall thickness and left ventricular diameter. In this group we observed statistically significant decrease of mean systolic blood pressure.
Conclusion 1. Left ventricular mass regression was observed both in pts. with APA and IHA after medical or surgical treatment. 2. Left ventricular mass regression in pts. with IHA without concomitant significant hypotensive effect suggests aldosterone influence on LVH. 3. Adrenalectomy in pts., with APA leads to more effective blood pressure lowering than spironolactone therapy in pts. with IHA.
Keywords: primary aldosteronismleft ventricular hypertrophyaldosteroneplasma renin activity