title: The Association between Glomerular Hyperfiltration and Left Ventricular Structure and Function in Patients with Primary Aldosteronism.
abstract: BACKGROUND
  Glomerular hyperfiltration has been recently noticed as an important issue in primary aldosteronism (PA) patients. However, its effect on the cardiovascular system remains unknown.
  
  
  METHODS
  We prospectively analyzed 47 PA patients including 11 PA patients with estimated glomerular filtration rate (eGFR) > 130 ml/min per 1.73 m2 (group 1), and 36 PA patients with eGFR 90-110 ml/min per 1.73 m2 (group 2). Fourteen essential hypertension (EH) patients with eGFR 90-110 ml/min per 1.73 m2 were included as the control group (group 3). Echocardiography including left ventricular mass index (LVMI) measurement and tissue Doppler imaging (TDI) was performed. Predicted left ventricular mass (LVM) was calculated. Inappropriate LVM was defined as an excess of > 35% from the predicted value.
  
  
  RESULTS
  The value of LVMI decreased significantly in order from groups 1 to 3 (group 1>2>3). While group 2 had a significantly higher percentage of inappropriate LVM than group 3, the percentage of inappropriate LVM were comparable in groups 1 and 2. Group 1 had a higher mitral E velocity, E/A ratio than that of group 2. In the TDI study, the E/E' ratio also decreased significantly in order from groups 1 to 3 (group 1>2>3). Group 2 had lower E' than that of group 3, although the E' of group 1 and 2 were comparable.
  
  
  CONCLUSIONS
  Although PA patients with glomerular hyperfiltration were associated with higher LVMI, higher mitral E velocity, higher E/E' ratio, they had comparable E' with PA patients with normal GFR. This phenomenon may be explained by higher intravascular volume in this patient group.
authors.affiliation: 1. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan;
authors.forename: Min-Tsun
authors.initials: MT
authors.lastname: Liao
authors.affiliation: 2. Department of Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan;
authors.forename: Xue-Ming
authors.initials: XM
authors.lastname: Wu
authors.affiliation: 3. Department of Medical Image, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Chin-Chen
authors.initials: CC
authors.lastname: Chang
authors.affiliation: 1. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan;
authors.forename: Che-Wei
authors.initials: CW
authors.lastname: Liao
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Ying-Hsien
authors.initials: YH
authors.lastname: Chen
authors.affiliation: 5. Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Ching-Chu
authors.initials: CC
authors.lastname: Lu
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Yen-Ting
authors.initials: YT
authors.lastname: Lin
authors.affiliation: 6. Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Yi-Yao
authors.initials: YY
authors.lastname: Chang
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Chi-Sheng
authors.initials: CS
authors.lastname: Hung
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Lung-Chun
authors.initials: LC
authors.lastname: Lin
authors.affiliation: 1. Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan;
authors.forename: Chao-Lun
authors.initials: CL
authors.lastname: Lai
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Vin-Cent
authors.initials: VC
authors.lastname: Wu
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Yi-Lwun
authors.initials: YL
authors.lastname: Ho
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
authors.affiliation: 4. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine. Taipei, Taiwan;
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
mesh_terms: D000328:Adult; D004452:Echocardiography; D000075222:Essential Hypertension; D005260:Female; D005919:Glomerular Filtration Rate; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D006929:Hyperaldosteronism / Q000503:physiopathology*; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology
keywords: Glomerular hyperfiltration; Left ventricular hypertrophy.; Primary aldosteronism