Factors influencing left ventricular mass regression in patients with primary aldosteronism post adrenalectomy.
BACKGROUND
Primary aldosteronism (PA) is a type of secondary hypertension with prominent left ventricular hypertrophy (LVH). Unilateral aldosterone-producing adenoma (APA) is the most common subtype that can be cured by adrenalectomy.


OBJECTIVE
To investigate left ventricular structural change after surgery and the factors associated with the degree of LVH regression in patients with PA.


METHODS
We performed a retrospective analysis in the Taiwan Primary Aldosteronism Investigation (TAIPAI) database, including demography, biochemical data, echocardiography and medication.


RESULTS
From July 1994 to January 2007, 20 patients (8 men) with APA receiving adrenalectomy and having pre- and postoperative echocardiography were selected. After 21 ± 19 months post operation, the left ventricular wall thickness and left ventricular mass index (LVMI) decreased significantly. The decrease of LVMI is significant only in patients who had LVH before operation. In analysis of factors associated with net LVMI decrease (ΔLVMI; post-operative LVMI - pre-operative LVMI), only pre-operative LVMI (r = -.783, p < .001), and ΔSBP (r = .472, p = .036) significantly correlated with ΔLVMI. In conclusion, LVH in PA could be significantly reversed by adrenalectomy. Pre-operative LVMI and ΔSBP were associated with the degree of LVMI decrease.


CONCLUSIONS
LVH in PA could be significantly reversed by adrenalectomy. Pre-operative LVMI and ΔSBP were associated with the degree of LVMI decrease.
Lin
Yen-Hung
YH
National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Huang
Kuo-How
KH
Lee
Jen-Kuang
JK
Wang
Shuo-Meng
SM
Yen
Ruoh-Fang
RF
Wu
Vin-Cent
VC
Chung
Shiu-Dong
SD
Liu
Kao-Lang
KL
Chueh
Shih-Chieh
SC
Lin
Lian-Yu
LY
Ho
Yi-Lwun
YL
Chen
Ming-Fong
MF
Wu
Kwan-Dun
KD
D000315:Adrenalectomy; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography