title: Epicardial Fat Thickness and Primary Aldosteronism.
abstract: Primary aldosteronism (PA) is associated with increased cardiovascular risk and left ventricle (LV) changes. Given its peculiar biomolecular and anatomic properties, excessive epicardial fat, the heart-specific visceral fat depot, can affect LV morphology. Whether epicardial fat can be associated with aldosterone and LV mass (LVM) in patients with PA is unknown. We performed ultrasound measurement of the epicardial fat thickness (EAT) in 79 consecutive newly diagnosed patients with PA, 59 affected by bilateral adrenal hyperplasia (IHA), 20 aldosterone-producing adenoma (APA), and 30 patients with essential hypertension (low renin hypertension) (EH). The 3 groups did not differ by age, sex distribution, body mass index (BMI), waist circumference (WC), or blood pressure values. EAT showed a trend of increase in both APA and IHA groups when compared to patients with EH (8.3±1.8 vs. 7.9±1.3 vs. 7.8±2 mm, respectively). EAT was significantly correlated with indexed LVM in the IHA group (r=0.35, p<005), better than BMI or WC were. Interestingly, EAT was highly associated with plasma aldosterone concentrations (PAC) and PAC/plasma renin activity (PRA) (PAC/PRA) in the APA group (p=0.58, p=0.37, p<0.01, for both), whereas BMI and WC were not. EAT was also correlated with PRA in the IHA group (p=-0.28, p<0.05). Our study indicates a novel and interesting interaction of EAT with PA, independent of obesity, abdominal fat and blood pressure control. EAT can locally affect LVM, at least in patients with IHA. Further studies in larger population will be required to confirm these findings.
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, USA.
authors.forename: G
authors.initials: G
authors.lastname: Iacobellis
authors.affiliation: Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University "La Sapienza", Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Petramala
authors.affiliation: Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University "La Sapienza", Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Marinelli
authors.affiliation: Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University "La Sapienza", Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Calvieri
authors.affiliation: Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University "La Sapienza", Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Zinnamosca
authors.affiliation: Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University "La Sapienza", Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Concistrè
authors.affiliation: Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University "La Sapienza", Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Iannucci
authors.affiliation: Department of Surgery "Pietro Valdoni", University "La Sapienza", Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: De Toma
authors.affiliation: Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University "La Sapienza", Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Letizia
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000378:metabolism; D001794:Blood Pressure; D005223:Fats / Q000737:chemistry / Q000378:metabolism*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000737:chemistry / Q000378:metabolism*
chemical_list: D005223:Fats; D000450:Aldosterone