Περίληψη:
Background: Primary aldosteronism (PA) has been experimentally and clinically linked to myocardial and vascular fibrosis, and it has been further associated with left ventricular (LV) structural adaptations. Hypothesis: Functional cardiovascular adaptations in hypertensive patients with PA precede structural alterations in the early stages of the disease. Methods: We studied 17 hypertensive subjects with a recent diagnosis of PA (10 male patients, aged approximately 55 y, with office blood pressure [BP] of 137/88 mm Hg), and 30 essential hypertensives matched for age, sex, office BP levels, treatment status, and LV mass index (LVMI). Apart from standard 2-Dimensional (2-D) and conventional Doppler parameters, tissue Doppler imaging (TDI) methodology was used to assess LV diastolic function; averaging early and late diastolic mitral annular peak velocities (Emav, Amav, Em av/Amav ratio) from 4 separate sites of measurement (septal, lateral, anterior, and inferior walls). Aortic stiffness was evaluated by means of carotid-femoral pulse wave velocity (cf-PWV) measurements. Results: Although transmitral E/A ratio was similar in both groups (0.95±0.26 versus 0.98±0.24, p = 0.66), hypertensive subjects with PA compared with essential hypertensives are characterized by significantly higher relative wall thickness (0.50±0.07 versus 0.41>0.06, p<0.001), decreased values of Emav (7±1.7 versus 8.1±1.8 cm/s, p = 0.048), and Emav/Amav ratio (0.63±0.16 versus 0.77±0.17, p = 0.015). The higher PWV in the PA population failed to reach statistical significance (8.5±1.6 versus 7.9±0.9 msec, p = 0.19). Conclusion: Our study demonstrates altered LV geometry and TDI-revealed diastolic dysfunction in hypertensives with PA compared with demographically- and LVMI-matched essential hypertensives. Furthermore, the increased aortic stiffening in PA patients failed to reach statistical significance. © 2008 Wiley Periodicals, Inc.
Συγγραφείς:
Tsioufis, C.
Tsiachris, D.
Dimitriadis, K.
Stougiannos, P.
Missovoulos, P.
Kakkavas, A.
Stefanadis, C.
Kallikazaros, I.
Λέξεις-κλειδιά:
adult; arterial stiffness; artery wall; article; blood pressure measurement; cardiac patient; carotid artery pulse; clinical article; demography; diastolic dysfunction; disease course; Doppler echography; essential hypertension; female; geometry; human; hypertension; male; methodology; mitral valve; myocardial disease; primary hyperaldosteronism; pulse wave; two dimensional echocardiography, Aorta; Echocardiography; Elasticity; Female; Heart; Humans; Hyperaldosteronism; Hypertension; Male; Middle Aged; Ventricular Function, Left; Ventricular Remodeling
