Document Detail

Cardiac remodeling in patients with primary aldosteronism.
MedLine Citation:
PMID:  19564719     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the morpho-functional changes of the myocardium in patients with primary aldosteronism (PA). DESIGN: An observational study in a university referral center for blood pressure diseases. PATIENTS: Twenty- three patients with PA, 24 patients with essential hypertension (EH), and 15 normotensive controls (C) underwent conventional echocardiography with integrated backscatter (IBS) and tissue Doppler imaging (TDI) analysis. The corrected IBS (C-IBS) values and the systo-diastolic variation of IBS (CV-IBS) were performed at both interventricular septum and the posterior wall levels. TDI myocardial systolic (Sm), early diastolic (Em), and late diastolic (Am) velocities of both left ventricular walls were also determined. RESULTS: In PA patients, septal and posterior wall CV-IBS were significantly lower than C (p<0.0001) and EH patients (p<0.001). In EH, CV-IBS was significantly lower than C (p<0.001). Patients with PA exhibited lower Sm, lower Em, and higher Am, and a subsequently reduced Em/Am ratio than C (p<0.001 for all) and EH (p<0.01 for all) at interventricular septum and lateral wall levels. In the latter, Sm, Em, and Em/Am ratio were lower and Am was higher than C (p<0.001 for all). In PA and EH patients, CV-IBS at both septum (r=-0.66, p<0.001) and posterior wall levels (r=-0.67, p<0.001) and Sm peak of both septum (r=-0.52, p<0.001) and lateral wall (r=-0.55, p<0.001) were inversely related to plasma aldosterone. CONCLUSIONS: Patients with PA showed myocardial wall remodeling characterized by increased myocardial fibrosis and early left ventricular systodiastolic function abnormalities.
F Galetta; G Bernini; F Franzoni; A Bacca; I Fivizzani; L Tocchini; M Bernini; P Fallahi; A Antonelli; G Santoro
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  32     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  739-45     Citation Subset:  IM    
Department of Internal Medicine, University of Pisa, 56100 Pisa, Italy.
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MeSH Terms
Heart / physiopathology*
Hyperaldosteronism / physiopathology*,  ultrasonography
Hypertension / physiopathology,  ultrasonography
Middle Aged

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