PP.09.10

Abstract

Objective: Primary aldosteronism (PA) has been the most common secondary cause of hypertension. The present study investigated the difference of left ventricular Structure and function in hypertensive patients with primary aldosteronism and essential hypertension. Design and method: Hypertensive patients from the hypertension department or clinic in Ruijin hospital were studied. The sample included 100 patients with primary aldosteronism and 100 controls with essential hypertension matched for age, gender, and 24-hour ambulatory monitoring BP. Left ventricular mass index (LVMI), LA volume index (LAVI), Ejection fraction were calculated. LV diastolic function was estimated by the ratio of early diastolic velocities (E) from transmitral inflow to early diastolic velocities (E’) of tissue Doppler at mitral annulus. Results: Primary aldosteronism and essential hypertension patients had similar LV dimensions, LV wall thickness, LVMI and LV systolic function. PA patients were associated with greater impairment in diastolic function as reflected by E’ (5.8 ± 1.9 cm/s vs. 6.6 ± 2.1 cm/s, respectively; p = 0.004), E/E’ ratio (13.5 ± 4.3 vs. 11.9 ± 3.3, respectively; p = 0.005) and higher left atrial volume index (23.0 ± 5.8 ml/m2 vs. 21.1 ± 5.5 ml/m2, respectively; p = 0.02). Multivariate analysis showed that E/E’ ratio independently correlated with age (β = 0.457, p < 0.001) and serum potassium (β = −0.230, p = 0.018). The left ventricular geometric, systolic functional parameters and patterns of LV-hypertrophy were similar in male patients between PA and EHT groups. While in female patients, PA was correlated with higher LVMI (103 ± 24 g/m2 vs. 93 ± 18 g/m2, respectively; p = 0.04) and lower RWT (0.38 ± 0.05 vs. 0.42 ± 0.04, respectively; p = 0.001). Conclusions: The increase in aldosterone levels could contribute to the impairment of LV diastolic function in both sexes and higher prevalence of eccentric hypertrophy in women than in men. LV diastolic function independently correlated with age and serum potassium in PA.