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Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism

BACKGROUND: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with change...

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Autores principales: Lim, Jung Soo, Hong, Namki, Park, Sungha, Park, Sung Il, Oh, Young Taik, Yu, Min Heui, Lim, Pil Yong, Rhee, Yumie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Endocrine Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279903/
https://www.ncbi.nlm.nih.gov/pubmed/30513563
http://dx.doi.org/10.3803/EnM.2018.33.4.485
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author Lim, Jung Soo
Hong, Namki
Park, Sungha
Park, Sung Il
Oh, Young Taik
Yu, Min Heui
Lim, Pil Yong
Rhee, Yumie
author_facet Lim, Jung Soo
Hong, Namki
Park, Sungha
Park, Sung Il
Oh, Young Taik
Yu, Min Heui
Lim, Pil Yong
Rhee, Yumie
author_sort Lim, Jung Soo
collection PubMed
description BACKGROUND: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Therefore, we investigated the impact of altered calcium homeostasis caused by excessive aldosterone on cardiovascular parameters in patients with PA. METHODS: Forty-two patients (mean age 48.8±10.9 years; 1:1, male:female) whose plasma aldosterone concentration/plasma renin activity ratio was more than 30 were selected among those who had visited Severance Hospital from 2010 to 2014. All patients underwent adrenal venous sampling with complete access to both adrenal veins. RESULTS: The prevalence of unilateral adrenal adenoma (54.8%) was similar to that of bilateral adrenal hyperplasia. Mean serum corrected calcium level was 8.9±0.3 mg/dL (range, 8.3 to 9.9). The corrected calcium level had a negative linear correlation with left ventricular end-diastolic diameter (LVEDD, ρ=−0.424, P=0.031). Moreover, multivariable regression analysis showed that the corrected calcium level was marginally associated with the LVEDD and corrected QT (QTc) interval (β=−0.366, P=0.068 and β=−0.252, P=0.070, respectively). CONCLUSION: Aldosterone-mediated hypercalciuria and subsequent hypocalcemia may be partly involved in the development of cardiac remodeling as well as a prolonged QTc interval, in subjects with PA, thereby triggering deleterious effects on target organs additively.
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spelling pubmed-62799032018-12-13 Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism Lim, Jung Soo Hong, Namki Park, Sungha Park, Sung Il Oh, Young Taik Yu, Min Heui Lim, Pil Yong Rhee, Yumie Endocrinol Metab (Seoul) Original Article BACKGROUND: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Therefore, we investigated the impact of altered calcium homeostasis caused by excessive aldosterone on cardiovascular parameters in patients with PA. METHODS: Forty-two patients (mean age 48.8±10.9 years; 1:1, male:female) whose plasma aldosterone concentration/plasma renin activity ratio was more than 30 were selected among those who had visited Severance Hospital from 2010 to 2014. All patients underwent adrenal venous sampling with complete access to both adrenal veins. RESULTS: The prevalence of unilateral adrenal adenoma (54.8%) was similar to that of bilateral adrenal hyperplasia. Mean serum corrected calcium level was 8.9±0.3 mg/dL (range, 8.3 to 9.9). The corrected calcium level had a negative linear correlation with left ventricular end-diastolic diameter (LVEDD, ρ=−0.424, P=0.031). Moreover, multivariable regression analysis showed that the corrected calcium level was marginally associated with the LVEDD and corrected QT (QTc) interval (β=−0.366, P=0.068 and β=−0.252, P=0.070, respectively). CONCLUSION: Aldosterone-mediated hypercalciuria and subsequent hypocalcemia may be partly involved in the development of cardiac remodeling as well as a prolonged QTc interval, in subjects with PA, thereby triggering deleterious effects on target organs additively. Korean Endocrine Society 2018-12 2018-11-30 /pmc/articles/PMC6279903/ /pubmed/30513563 http://dx.doi.org/10.3803/EnM.2018.33.4.485 Text en Copyright © 2018 Korean Endocrine Society http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lim, Jung Soo
Hong, Namki
Park, Sungha
Park, Sung Il
Oh, Young Taik
Yu, Min Heui
Lim, Pil Yong
Rhee, Yumie
Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism
title Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism
title_full Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism
title_fullStr Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism
title_full_unstemmed Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism
title_short Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism
title_sort effects of altered calcium metabolism on cardiac parameters in primary aldosteronism
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6279903/
https://www.ncbi.nlm.nih.gov/pubmed/30513563
http://dx.doi.org/10.3803/EnM.2018.33.4.485
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