A-005 MYOCARDIAL ULTRASOUND TISSUE CHARACTERIZATION IN PATIENTSWITH PRIMARY ALDOSTERONISM

Abstract

Background Primary aldosteronism (PA), an underdiagnosed cause of hypertension, causes cardiac remodeling and myocardial fibrosis. Ultrasonic tissue characterization by cyclic variation ofintegrated backscatter(CVIBS) is a useful tool to evaluate the extent of myocardial fibrosis. The aim of this study is to assess the myocardial fibrosis caused by primary aldosteronism and to evaluate the relationship among CVIBS and baseline clinical parameters of PA patients. Methods We prospectively analyzed 62 patients with PA (including 46 patients with aldosterone-producing adenoma and 16 with bilateral hyperplasia) from October 2006 to October 2010, and 17 patients with essential hypertension (EH) were enrolled asthe control group. Echocardiography, included ultrasonic tissue characterization by CVIBS, was performed in both groups. Results In patients with PA, diastolic blood pressure and plasma aldosterone concentration were significantly higherthan patients with EH. Meanwhile, serum potassium level and plasma renin activity were significantly lower than patients with EH. In echocardiography, patients with PA had thickerinterventricularseptal thickness, left ventricular posterior wall thickness, and higher left ventricularmass index than EH patients. Patients with PA had significant lower CVIBS than EH patients (7.1 ± 2.2vs 8.7 ± 1.5 dB, P = .005). In correlation study, among various clinical parameters, only log-transformed plasma renin activity was correlated significantly with CVIBS. Conclusion Ultrasonic tissue characterization with CVIBS is a useful tool to detect the extent of myocardial fibrosis. PA patients have more severe degree of myocardial fibrosis detected by CVIBS. The severity of fibrosis detecting by CVIBS is correlated with log-transformed plasma renin activity.