A-007 SEROLOGICAL EVIDENCE OF MYOCARDIAL FIBROSIS REVERSALIN PATIENTS WITH ALDOSTERONE PRODUCING ADENOMA RECEIVING ADRENALECTOMY

Abstract

Background Primary aldosteronism (PA) is the most frequent cause of secondary hypertension and is associated with increased myocardial fibrosis.Carboxy-terminal propeptide of procollagen type I (PICP) is a useful serological marker to reflect the severity of myocardial fibrosis. Aldosterone producing adenoma (APA) can be cured by adrenalectomy. Reversal of myocardial fibrosis after adrenalectomy isunclear. Methods We analyzed 29 patients prospectively with APA who received adrenalectomy from October 2006 to October 2008, and 22 patients with essential hypertension (EH) were enrolled as the control group. PICP level was checked before operation and 1 year after operation in the APA patients. Results Patients with APA had significantly higher systolic and diastolic blood pressure, higher plasma aldosterone concentration (PAC), lower serum potassium level, and lower plasma renin activity (PRA) than patients with EH. Patients with APA had significant higherlevel of PICP than EH patients (107 ± 32vs89 ± 26 μg/L, P = 0.038). Serum PICP level was significantly correlated with creatinine level, log-transformed PAC, log-transformed PRA, and log-transformed aldosterone to renin ratio. One year after adrenalectomy, PICP level decreased significantly (107 ± 32 to 87 ± 28 μg/L, P = 0.008). Conclusions The PICP level was higher in patients withAPA than with EH. Adrenalectomy decreased the PICP level in APA patients. This finding implies that myocardial fibrosis of patients with APA might be decreased by adrenalectomy.