The association of serum potassium level with left ventricular mass in patients with primary aldosteronism.
BACKGROUND
Primary aldosteronism (PA) is associated a worse cardiovascular outcome than essential hypertension. Hypokalemia, which is one major characteristic of PA, can affect both cardiac structure and function. The goal of this study is to evaluate the influence of serum potassium level on left ventricular (LV) mass and function in PA patients.


METHODS
We prospectively analysed 85 PA patients from October 2006 to September 2008 and 27 essential hypertension patients as the control group (group 1). Thirty-two patients with serum potassium < 3·5 mmol L(-1) were defined as hypokalemia (group 2), and 53 patients with serum potassium ≥ 3·5 mmol L(-1) were defined as normokalemia (group 3). Echocardiography including tissue Doppler image (TDI) recordings was performed in all patients.


RESULTS
Group 2 patients had significant higher systolic and diastolic blood pressure (DBP), log-transformed plasma aldosterone concentration, log-transformed aldosterone-to-renin ratio and lower serum potassium level than groups 1 and 3. In echocardiographic measurement, group 2 patients had higher LV mass index (LVMI) than groups 1 and 3. In multivariate analysis for factors affecting LVMI in PA patients, only serum potassium level (P = 0·001), use of spironolactone (P = 0·004) and DBP (P = 0·005) were independent factors. In the TDI study, both groups 2 and 3 had lower e' and E/e' values than group 1.


CONCLUSIONS
Serum potassium level is significantly associated with LVMI in PA patients. Compared with essential hypertensive patients, PA patients had a greater impairment of cardiac diastolic function.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Yen-Hung
YH
Lin
Shuo-Meng
SM
Wang
Vin-Cent
VC
Wu
Jen-Kuang
JK
Lee
Chin-Chi
CC
Kuo
Ruoh-Fang
RF
Yen
Kao-Lang
KL
Liu
Kuo-How
KH
Huang
Shih-Chieh
SC
Chueh
Wei-Jie
WJ
Wang
Lian-Yu
LY
Lin
Kuo-Long
KL
Chien
Yi-Lwun
YL
Ho
Ming-Fong
MF
Chen
Kwan-Dun
KD
Wu
D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood*; D011446:Prospective Studies; D014463:Ultrasonography
D000450:Aldosterone; D011188:Potassium