Reversible heart rhythm complexity impairment in patients with primary aldosteronism.
Excess aldosterone secretion in patients with primary aldosteronism (PA) impairs their cardiovascular system. Heart rhythm complexity analysis, derived from heart rate variability (HRV), is a powerful tool to quantify the complex regulatory dynamics of human physiology. We prospectively analyzed 20 patients with aldosterone producing adenoma (APA) that underwent adrenalectomy and 25 patients with essential hypertension (EH). The heart rate data were analyzed by conventional HRV and heart rhythm complexity analysis including detrended fluctuation analysis (DFA) and multiscale entropy (MSE). We found APA patients had significantly decreased DFAα2 on DFA analysis and decreased area 1-5, area 6-15, and area 6-20 on MSE analysis (all p < 0.05). Area 1-5, area 6-15, area 6-20 in the MSE study correlated significantly with log-transformed renin activity and log-transformed aldosterone-renin ratio (all p < = 0.01). The conventional HRV parameters were comparable between PA and EH patients. After adrenalectomy, all the altered DFA and MSE parameters improved significantly (all p < 0.05). The conventional HRV parameters did not change. Our result suggested that heart rhythm complexity is impaired in APA patients and this is at least partially reversed by adrenalectomy.
Department of internal medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Yen-Hung
YH
Lin
Department of internal medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Vin-Cent
VC
Wu
Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan.
Men-Tzung
MT
Lo
Department of Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan.
Xue-Ming
XM
Wu
Department of internal medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Chi-Sheng
CS
Hung
Department of internal medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Kwan-Dun
KD
Wu
Center for Dynamical Biomarkers and Translational Medicine, National Central University, Chungli, Taiwan.
Chen
C
Lin
Department of internal medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Yi-Lwun
YL
Ho
Endocrine Hypertension Research Center, University of Queensland School of Medicine, Greenslopes and Princess Alexandra Hospitals, Brisbane, Australia.
Michael
M
Stowasser
Division of Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA.
Chung-Kang
CK
Peng
D000450:Aldosterone / Q000378:metabolism*; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology*; D001683:Biological Clocks; D003198:Computer Simulation; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005260:Female; D006339:Heart Rate; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular
D000450:Aldosterone