Twenty-four-hour urinary aldosterone predicts inappropriate left ventricular mass index in patients with primary aldosteronism.
OBJECTIVE
Primary aldosteronism (PA) is associated with inappropriate left ventricular hypertrophy (LVH) in relation to a given gender and body size. There is no ideal parameter to predict the presence of LVH or inappropriate LVH in patients with PA. We investigate the performance of 24-hour urinary aldosterone level, plasma renin activity and aldosterone-to-renin ratio on this task.


METHODS
We performed echocardiography in 106 patients with PA and 31 subjects with essential hypertension (EH) in a tertiary teaching hospital. Plasma renin activity, aldosterone concentration, and 24-hour urinary aldosterone level were measured.


RESULTS
Only 24-hour urinary aldosterone was correlated with left ventricular mass index (LVMI) and excess LVMI among these parameters. The multivariate analysis revealed the urinary aldosterone level as an independent predictor for LVMI and excess LVMI. Analyzing the ability of urinary aldosterone, plasma aldosterone concentration, and plasma aldosterone-to-renin ratio to identify the presence of LVH (ROC AUC = 0.701, 0.568, 0.656, resp.) and the presence of inappropriate LV mass index (defined as measured LVMI in predicting LVMI ratio >135%) (ROC area under curve = 0.61, 0.43, 0.493, resp.) revealed the better performance of 24-hour urinary aldosterone.


CONCLUSIONS
In conclusion, 24-hour urinary aldosterone level performed better to predict the presence of LVH and inappropriate LVMI in patients with PA.
Telehealth Center, National Taiwan University Hospital, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan ; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Chi-Sheng
CS
Hung
Telehealth Center, National Taiwan University Hospital, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan ; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Yi-Lwun
YL
Ho
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Yi-Yao
YY
Chang
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Vin-Cent
VC
Wu
Department of Internal Medicine, Taoyuan General Hospital, Taoyuan 330, Taiwan.
Xue-Ming
XM
Wu
Department of Laboratory Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan.
Jen-Kuang
JK
Lee
Department of Urology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan ; Department of Urology, Cleveland Clinic, Cleveland, OH 44011, USA.
Shih-Chieh
SC
Chueh
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Yen-Hung
YH
Lin
Department of Internal Medicine, Postal Hospital, Taipei 100, Taiwan.
Yuan-Shian
YS
Changh
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Shao-Yu
SY
Yang
Internal Medicine, Buddhist Tzu Chi General Hospital, New Taipei City 231, Taiwan.
Ya-Hui
YH
Hu
Institute of Pharmacology, National Taiwan University Medical College, Taipei 100, Taiwan.
Ming-Jai
MJ
Sui
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Ming-Fong
MF
Chen
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan.
Kwan-Dun
KD
Wu
D000368:Aged; D000450:Aldosterone / Q000652:urine*; D049628:Body Size; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000150:complications / Q000652:urine*; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000150:complications / Q000652:urine*; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood; D012727:Sex Characteristics; D012737:Sex Factors
D000450:Aldosterone; D012083:Renin