Cargando…

Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging

BACKGROUND: Primary aldosteronism is the most common cause of secondary hypertension and is associated with left ventricular hypertrophy. However, whether aldosterone excess is responsible for left ventricular (LV) diastolic dysfunction is unknown. METHODS AND RESULTS: We prospectively enrolled 129...

Descripción completa

Detalles Bibliográficos
Autores principales: Chang, Yi‐Yao, Liao, Che‐Wei, Tsai, Cheng‐Hsuan, Chen, Ching‐Way, Pan, Chien‐Ting, Chen, Zheng‐Wei, Chen, Ya‐Li, Lin, Lung‐Chun, Chang, Yi‐Ru, Wu, Vin‐Cent, Wu, Kwan‐Dun, Hung, Chi‐Sheng, Lin, Yen‐Hung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915298/
https://www.ncbi.nlm.nih.gov/pubmed/31718437
http://dx.doi.org/10.1161/JAHA.119.013263
_version_ 1783479984353968128
author Chang, Yi‐Yao
Liao, Che‐Wei
Tsai, Cheng‐Hsuan
Chen, Ching‐Way
Pan, Chien‐Ting
Chen, Zheng‐Wei
Chen, Ya‐Li
Lin, Lung‐Chun
Chang, Yi‐Ru
Wu, Vin‐Cent
Wu, Kwan‐Dun
Hung, Chi‐Sheng
Lin, Yen‐Hung
author_facet Chang, Yi‐Yao
Liao, Che‐Wei
Tsai, Cheng‐Hsuan
Chen, Ching‐Way
Pan, Chien‐Ting
Chen, Zheng‐Wei
Chen, Ya‐Li
Lin, Lung‐Chun
Chang, Yi‐Ru
Wu, Vin‐Cent
Wu, Kwan‐Dun
Hung, Chi‐Sheng
Lin, Yen‐Hung
author_sort Chang, Yi‐Yao
collection PubMed
description BACKGROUND: Primary aldosteronism is the most common cause of secondary hypertension and is associated with left ventricular hypertrophy. However, whether aldosterone excess is responsible for left ventricular (LV) diastolic dysfunction is unknown. METHODS AND RESULTS: We prospectively enrolled 129 patients with aldosterone‐producing adenoma and 120 patients with essential hypertension, and analyzed their clinical, biochemical, and echocardiographic data, including tissue Doppler images. The patients with aldosterone‐producing adenoma were reevaluated 1 year after adrenalectomy. After propensity score matching, there were 105 patients in each group. The patients with aldosterone‐producing adenoma had worse diastolic function than the patients with essential hypertension, as reflected by lower e′ (P<0.001) and higher E/e′ (P=0.003). Multivariate analysis showed that LV diastolic function was significantly correlated with age (P<0.001), sex (P<0.001), body mass index (P=0.002), systolic blood pressure (P=0.004), creatinine (P=0.008), and log‐transformed aldosterone‐renin ratio (P=0.003). After adrenalectomy, the patients with aldosterone‐producing adenoma had significant improvements in LV diastolic function as reflected by an increase in e′ (P=0.003) and decrease in E/e′ (P=0.002). The change in E/e′ was independently correlated with baseline E/e′ (P<0.001) and change in LV mass index (P=0.006). CONCLUSIONS: The patients with primary aldosteronism had worse LV diastolic function than the patients with essential hypertension after propensity score matching, and this could be reversed after adrenalectomy, suggesting that aldosterone excess may induce LV diastolic dysfunction.
format Online
Article
Text
id pubmed-6915298
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-69152982019-12-23 Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging Chang, Yi‐Yao Liao, Che‐Wei Tsai, Cheng‐Hsuan Chen, Ching‐Way Pan, Chien‐Ting Chen, Zheng‐Wei Chen, Ya‐Li Lin, Lung‐Chun Chang, Yi‐Ru Wu, Vin‐Cent Wu, Kwan‐Dun Hung, Chi‐Sheng Lin, Yen‐Hung J Am Heart Assoc Original Research BACKGROUND: Primary aldosteronism is the most common cause of secondary hypertension and is associated with left ventricular hypertrophy. However, whether aldosterone excess is responsible for left ventricular (LV) diastolic dysfunction is unknown. METHODS AND RESULTS: We prospectively enrolled 129 patients with aldosterone‐producing adenoma and 120 patients with essential hypertension, and analyzed their clinical, biochemical, and echocardiographic data, including tissue Doppler images. The patients with aldosterone‐producing adenoma were reevaluated 1 year after adrenalectomy. After propensity score matching, there were 105 patients in each group. The patients with aldosterone‐producing adenoma had worse diastolic function than the patients with essential hypertension, as reflected by lower e′ (P<0.001) and higher E/e′ (P=0.003). Multivariate analysis showed that LV diastolic function was significantly correlated with age (P<0.001), sex (P<0.001), body mass index (P=0.002), systolic blood pressure (P=0.004), creatinine (P=0.008), and log‐transformed aldosterone‐renin ratio (P=0.003). After adrenalectomy, the patients with aldosterone‐producing adenoma had significant improvements in LV diastolic function as reflected by an increase in e′ (P=0.003) and decrease in E/e′ (P=0.002). The change in E/e′ was independently correlated with baseline E/e′ (P<0.001) and change in LV mass index (P=0.006). CONCLUSIONS: The patients with primary aldosteronism had worse LV diastolic function than the patients with essential hypertension after propensity score matching, and this could be reversed after adrenalectomy, suggesting that aldosterone excess may induce LV diastolic dysfunction. John Wiley and Sons Inc. 2019-11-13 /pmc/articles/PMC6915298/ /pubmed/31718437 http://dx.doi.org/10.1161/JAHA.119.013263 Text en © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Chang, Yi‐Yao
Liao, Che‐Wei
Tsai, Cheng‐Hsuan
Chen, Ching‐Way
Pan, Chien‐Ting
Chen, Zheng‐Wei
Chen, Ya‐Li
Lin, Lung‐Chun
Chang, Yi‐Ru
Wu, Vin‐Cent
Wu, Kwan‐Dun
Hung, Chi‐Sheng
Lin, Yen‐Hung
Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging
title Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging
title_full Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging
title_fullStr Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging
title_full_unstemmed Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging
title_short Left Ventricular Dysfunction in Patients With Primary Aldosteronism: A Propensity Score–Matching Follow‐Up Study With Tissue Doppler Imaging
title_sort left ventricular dysfunction in patients with primary aldosteronism: a propensity score–matching follow‐up study with tissue doppler imaging
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915298/
https://www.ncbi.nlm.nih.gov/pubmed/31718437
http://dx.doi.org/10.1161/JAHA.119.013263
work_keys_str_mv AT changyiyao leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT liaochewei leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT tsaichenghsuan leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT chenchingway leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT panchienting leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT chenzhengwei leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT chenyali leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT linlungchun leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT changyiru leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT wuvincent leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT wukwandun leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT hungchisheng leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT linyenhung leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging
AT leftventriculardysfunctioninpatientswithprimaryaldosteronismapropensityscorematchingfollowupstudywithtissuedopplerimaging