Evidence for abnormal left ventricular structure and function in normotensive individuals with familial hyperaldosteronism type I

Stowasser, Michael, Sharman, James, Leano, Rodel, Gordon, Richard D., Ward, Gregory, Cowley, Diane and Marwick, Thomas H. (2005) Evidence for abnormal left ventricular structure and function in normotensive individuals with familial hyperaldosteronism type I. Journal of Clinical Endocrinology and Metabolism, 90 9: 5070-5076. doi:10.1210/jc.2005-0681


Author Stowasser, Michael
Sharman, James
Leano, Rodel
Gordon, Richard D.
Ward, Gregory
Cowley, Diane
Marwick, Thomas H.
Title Evidence for abnormal left ventricular structure and function in normotensive individuals with familial hyperaldosteronism type I
Journal name Journal of Clinical Endocrinology and Metabolism   Check publisher's open access policy
ISSN 0021-972X
Publication date 2005-09-01
Sub-type Article (original research)
DOI 10.1210/jc.2005-0681
Volume 90
Issue 9
Start page 5070
End page 5076
Total pages 7
Place of publication Chevy Chase, U.S.A.
Publisher The Endocrine Society
Collection year 2005
Language eng
Subject C1
321004 Endocrinology
730105 Endocrine organs and diseases (incl. diabetes)
321003 Cardiology (incl. Cardiovascular Diseases)
730106 Cardiovascular system and diseases
1103 Clinical Sciences
110306 Endocrinology
1102 Cardiovascular Medicine and Haematology
Formatted abstract
Objectives:  To explore whether aldosterone excess can induce adverse cardiovascular effects independently of effects on blood pressure (BP), we sought evidence of disturbed cardiovascular structure or function in normotensive individuals with primary aldosteronism.

Methods:
  Eight normotensive subjects with genetically proven familial hyperaldosteronism type I (FH-I) were compared with 24 age- and sex-matched normotensive controls in terms of BP, biochemical parameters, pulse wave velocity, and echocardiographic characteristics.

Results:  Subjects with FH-I demonstrated higher serum aldosterone levels and aldosterone/ renin ratios than controls, as expected. Despite having similar 24-h ambulatory BPs, subjects with FH-I demonstrated evidence of concentric remodeling with greater septal (mean +/- SD, 9.4 +/- 1.1 vs. 7.9 +/- 0.9 mm; P < 0.001), posterior wall ( 9.2 +/- 1.7 vs. 7.7 +/- 1.0 mm; P < 0.01), and relative wall (0.29 +/- 0.03 vs. 0.24 +/- 0.02; P < 0.001) thicknesses, and lower mitral early peak velocities (0.74 +/- 0.10 vs. 0.90 +/- 0.16 m/ sec; P < 0.05), ratios of early to late peak diastolic transmitral flow velocity (1.56 +/- 0.24 vs. 2.06 +/- 0.41; P < 0.01), and myocardial early peak velocities (8.3 +/- 1.8 vs. 10.3 +/- 2.6 cm/sec; P < 0.05). There were no significant differences in pulse wave velocity or left ventricular ejection fraction, long axis strain rate, peak systolic strain, cyclic variation of integrated backscatter, or posterior wall calibrated integrated backscatter.

Conclusions:  Aldosterone excess is associated with increased left ventricular wall thicknesses and reduced diastolic function, even in the absence of hypertension.
Keyword Glucocorticoid-remediable aldosteronism
Hypertensive patients
Diastolic function
Heart-failure
Echocardiographic assessment
Pathological hypertrophy
Doppler-echocardiography
Tissue characterization
Myocardial fibrosis
Oral-contraceptives
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 15:38:07 EST