Left ventricular systolic function in primary aldosteronism and hypertension.
OBJECTIVE
This study was designed to investigate whether the excess aldosterone found in primary aldosteronism (PA) influences left-ventricular systolic function (LVSF), through a positive inotropic effect


METHODS
M-mode and two-dimensional echocardiography and transmitral Doppler flow velocity measurements were performed in 82 patients: 44 with confirmed PA (23 male; 21 female; aged 51.8+/-13 years) and 38 essential hypertension patients (16 male; 22 female; aged 48.5+/-12 years) matched for demography and blood pressure (BP) values. We measured left-ventricular (LV) midwall fractional shortening (MwFSho) and LV circumferential end-systolic stress (cESS, calculated according to Reichek's equation) and analysed the relationship between MwFSho and cESS.


RESULTS
These are given as the mean +/- standard deviation. PA patients had significantly higher cardiac index (CI) (3.55+/-0.94 l/m2 vs 2.98+/-0.58, P < 0.005) and lower E wave/A wave time-velocity integral ratio (0.93+/-0.27 vs 1.26+/-0.41, P < 0.001) than EH, whereas mean BP (126+/-12 mmHg vs 128+/-12), MwFSho (17.1+/-2.4% vs 16.3+/-1.9), cESS (118+/-19 Kdynes/cm2 vs 121+/-18) and the relationship between LV MwFSho and LV cESS did not differ between groups.


CONCLUSIONS
These findings confirm that PA patients exhibit: (1) a modest increase of CI; (2) an LV diastolic filling mainly occurring with the atrial kick. However, they do not lend support to the contention that the excess of plasma aldosterone seen in PA is associated with enhanced LV inotropism under resting conditions.
Rossi
G P
GP
Department of Clinical and Experimental Medicine, Clinica Medica 4, University of Padua Medical School and Azienda Ospedaliera di Padova, Italy. gprossi@ux1.unipd.it
Sacchetto
A
A
Pavan
E
E
Scognamiglio
R
R
Pietra
M
M
Pessina
A C
AC
D000328:Adult; D000450:Aldosterone / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013599:Systole / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
D000450:Aldosterone