Open AccessMyocardial and Aortic Stiffening in the Early Course of Primary Aldosteronism
Author(s) -
Tsioufis Costas,
Tsiachris Dimitrios,
Dimitriadis Kyriakos,
Stougiannos Pavlos,
Missovoulos Platonas,
Kakkavas Apostolis,
Stefanadis Christodoulos,
Kallikazaros Ioannis
Publication year - 2008
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20270
Subject(s) - medicine , primary aldosteronism , cardiology , pulse wave velocity , diastole , blood pressure , doppler imaging , essential hypertension , hypertensive heart disease , population , myocardial fibrosis , doppler echocardiography , pulse pressure , fibrosis , heart failure , environmental health
Background Primary aldosteronism (PA) has been experimentally and clinically linked to myocardial and vascular fibrosis, and it has been further associated with left ventricular (LV) structural adaptations. Hypothesis Functional cardiovascular adaptations in hypertensive patients with PA precede structural alterations in the early stages of the disease. Methods We studied 17 hypertensive subjects with a recent diagnosis of PA (10 male patients, aged approximately 55 y, with office blood pressure [BP] of 137/88 mm Hg), and 30 essential hypertensives matched for age, sex, office BP levels, treatment status, and LV mass index (LVMI). Apart from standard 2‐Dimensional (2‐D) and conventional Doppler parameters, tissue Doppler imaging (TDI) methodology was used to assess LV diastolic function; averaging early and late diastolic mitral annular peak velocities (Em av /, Am av , Em av /Am av ratio) from 4 separate sites of measurement (septal, lateral, anterior, and inferior walls). Aortic stiffness was evaluated by means of carotid‐femoral pulse wave velocity (cf‐PWV) measurements. Results Although transmitral E/A ratio was similar in both groups (0.95 ± 0.26 versus 0.98 ± 0.24, ± p 0.66), hypertensive subjects with PA compared with essential hypertensives are characterized by significantly higher relative wall thickness (0.50 ± 0.07 versus 0.41 ± 0.06, p ≤ 0.001), decreased values of Em av (7 ± 1.7 versus 8.1 ± 1.8 cm/s, p= 0.048), and Em av /Am av ratio (0.63 ± 0.16 versus 0.77 ± 0.17, p = 0.015). The higher PWV in the PA population failed to reach statistical significance (8.5 ± 1.6 versus 7.9 ± 0.9 msec, p = 0.19). Conclusion Our study demonstrates altered LV geometry and TDI‐revealed diastolic dysfunction in hypertensives with PA compared with demographically‐ and LVMI‐matched essential hypertensives. Furthermore, the increased aortic stiffening in PA patients failed to reach statistical significance. Copyright © 2008 Wiley Periodicals, Inc.