Abstract
ObjectivesThe main cardiac features of primary aldosteronism (PA) are impaired left ventricular (LV) diastolic function, and some articles also reported more cardiac fibrosis in PA patients. However, the correlation between LV dysfunction and diffuse myocardial fibrosis in PA remains unknown.MethodsWe enrolled 84 PA patients and 28 essential hypertension (EH) patients in West China Hospital. Cardiac magnetic resonance imaging (CMR) contrast enhancement was arranged for all subjects. Postcontrast T1 time and left ventricular myocardial strains and strain rates were measured.Results76 PA patients and 27 essential hypertension (EH) patients were included in the final analysis. Blood pressure, LV mass indexes, and LV ejection fractions were comparable in both groups, while the global circumferential peak diastolic strain rate (PDSR) was lower (0.9 ± 0.3 vs. 1.1 ± 0.4, p <0.01) and the postcontrast T1 time was shorter (520 ± 38 vs. 538 ± 27, p = 0.01) in PA patients than those in EH patients. Postcontrast T1 time (p = 0.01) was independently related to global circumferential PDSR after adjusting for age and duration of hypertension in PA patients. Furthermore, plasma aldosterone concentration was negatively associated with postcontrast T1 time (R = −0.253, p = 0.028) in PA patients.ConclusionsThe global circumferential PDSR derived by CMR is decreased, and the diffuse myocardial fibrosis is increased in PA patients compared to those in blood pressure matched EH patients. The severity of cardiac diastolic dysfunction independently relates to the degree of diffuse myocardial fibrosis in PA patients, and the diffuse myocardial fibrosis may be caused by high PAC level.Clinical Trial Registration http://www.chictr.org.cn/listbycreater.asp, identifier ChiCTR2000031792.
Highlights
Primary aldosteronism (PA), characterized by the overproduction of aldosterone that seems autonomous from renin [1], is the most common endocrine cause of hypertension and contributes more than 10% to the etiology of hypertension [2] and 29.1% to the etiology of resistant hypertension [3]
left ventricular (LV) mass indexes, and LV ejection fractions were comparable in both groups, while the global circumferential peak diastolic strain rate (PDSR) was lower (0.9 ± 0.3 vs. 1.1 ± 0.4, p
The global circumferential PDSR derived by Cardiac magnetic resonance imaging (CMR) is decreased, and the diffuse myocardial fibrosis is increased in PA patients compared to those in blood pressure matched EH patients
Summary
Primary aldosteronism (PA), characterized by the overproduction of aldosterone that seems autonomous from renin [1], is the most common endocrine cause of hypertension and contributes more than 10% to the etiology of hypertension [2] and 29.1% to the etiology of resistant hypertension [3]. Reincke et al [8] reported that cardiovascular mortality was the leading cause of death in PA (50%) and occurred less frequently in EH controls (34%). Studies have found that cardiac dysfunction results from fibrosis of the myocardium in many diseases, such as heart failure [12], hypertrophic cardiomyopathy [13], and diabetic patients [14]. A late gadolinium enhancement study using cardiac magnetic imaging (CMR) proved that patients with PA exhibit more frequent diffuse myocardial fibrosis than healthy volunteers [16] and EH patients [17]. Gretaas et al [15] reported that increased myocardial fibrosis was not found and may not represent a common clinical problem in PA
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
