title: Electrical and Myocardial Remodeling in Primary Aldosteronism.
abstract: OBJECTIVE
  Primary aldosteronism (PA) represents the most common cause of secondary hypertension. A higher risk of cardiovascular events has been reported in patients with PA than in otherwise similar patients with essential hypertension (EH). So far, only a few studies investigated the electrocardiographic changes in PA patients compared to EH patients.
  
  
  METHODS
  To investigate the electrocardiographic changes and heart remodeling in PA, we enrolled 61 consecutive patients, 30 with PA [12 with aldosterone-producing adrenal cortical adenoma (APA) and 18 with bilateral adrenal hyperplasia-idiopathic adrenal hyperplasia] and 30 with EH. In all subjects, electrocardiographic parameters were evaluated from 12-lead electrocardiograms and heart remodeling with echocardiogram.
  
  
  RESULTS
  No significant differences in age, sex, body mass index, and blood pressure were found in two groups. The P wave and PR interval duration were significantly prolonged in patients with PA respect to EH (p < 0.003 and <0.002, respectively). A first degree atrio-ventricular block was present in 16% of the patients with PA and only in 3.2% of those with EH. In PA patients, the interventricular septum thickness (IVST) correlated with PR duration (r = 0.51; p < 0.03). Left ventricular hypertrophy was present in 53% of the patients with PA and in 26% of the patients with EH (χ(2), p < 0.03).
  
  
  CONCLUSIONS
  In this case-control study, patients with PA show more anatomic and electrical heart remodeling than those with EH. We hypothesize that in patients with PA these cardiac changes may play a role for the increased risk of future cardiovascular events.
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Rome , Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Curione
authors.affiliation: Specialized Center of Secondary Hypertension, Sapienza University of Rome , Rome , Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Petramala
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Rome , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Savoriti
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Rome , Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: Verrenti
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Rome , Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Baiocco
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Rome , Italy.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Salvatore
authors.affiliation: Specialized Center of Secondary Hypertension, Sapienza University of Rome , Rome , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Zinnamosca
authors.affiliation: Specialized Center of Secondary Hypertension, Sapienza University of Rome , Rome , Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Iannucci
authors.affiliation: Specialized Center of Secondary Hypertension, Sapienza University of Rome , Rome , Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Sciomer
authors.affiliation: Specialized Center of Secondary Hypertension, Sapienza University of Rome , Rome , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Letizia
keywords: conduction disturbance; electrocardiography; essential hypertension; hyperaldosteronism; left ventricular hypertrophy