title: Echocardiographic comparison of left ventricular structure and function in hypertensive patients with primary aldosteronism and essential hypertension.
abstract: BACKGROUND
  In experimental renovascular hypertension, aldosterone has been implicated in myocardial remodeling and fibrosis, but it is uncertain whether excess aldosterone effects left ventricular structure and function in hypertensive patients.
  
  
  METHODS
  Hypertensive patients from the Cardiovascular Center of the New York Presbyterian Hospital-Weill Cornell Medical Center in New York and the Russian Cardiovascular Research Institute, Moscow, Russia, were studied. The sample included 35 patients with primary aldosteronism and 35 controls with essential hypertension matched for age, gender, and blood pressure (BP). Left ventricular (LV) mass, endocardial and midwall fractional shortening, and circumferential end-systolic stress were calculated. The observed/predicted midwall shortening ratio was used as an index of LV performance corrected for afterload.
  
  
  RESULTS
  Primary aldosteronism and essential hypertension patients had comparable LV dimensions, wall thickness, mass, mass/body surface area, and mass/height. Endocardial and midwall fractional shortening, and afterload-corrected midwall shortening were similar in primary aldosteronism and essential hypertension groups from both clinics. Moreover, logistic regression analysis using BP, body mass index, height, gender, and center as covariates failed to identify statistical differences in LV geometry or systolic function between primary aldosteronism and essential hypertension patients.
  
  
  CONCLUSIONS
  Patients with primary aldosteronism, a state characterized by chronic aldosterone excess, had similar LV geometry and systolic function compared to essential hypertension patients matched for age, gender, and BP. This argues against important independent associations between aldosterone and these aspects of LV response to human hypertension.
authors: Division of Cardiology, New York Presbyterian Hospital-Weill Cornell Medical Center, New York 10021, USA.
authors: Ronen
authors: R
authors: Goldkorn
authors: Alexei
authors: A
authors: Yurenev
authors: Jon
authors: J
authors: Blumenfeld
authors: Dawn
authors: D
authors: Fishman
authors: Richard B
authors: RB
authors: Devereux
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009206:Myocardium / Q000473:pathology*