Cardiac Dysfunction in Association with Increased Inflammatory Markers in Primary Aldosteronism.
BACKGROUND
Oxidative stress in primary aldosteronism (PA) is thought to worsen aldosterone-induced damage by activating proinflammatory processes. Therefore, we investigated whether inflammatory markers associated with oxidative stress is increased with negative impacts on heart function as evaluated by echocardiography in patients with PA.


METHODS
Thirty-two subjects (mean age, 50.3±11.0 years; 14 males, 18 females) whose aldosterone-renin ratio was more than 30 among patients who visited Severance Hospital since 2010 were enrolled. Interleukin-1β (IL-1β), IL-6, IL-8, monocyte chemoattractant protein 1, tumor necrosis factor α (TNF-α), and matrix metalloproteinase 2 (MMP-2), and MMP-9 were measured. All patients underwent adrenal venous sampling with complete access to both adrenal veins.


RESULTS
Only MMP-2 level was significantly higher in the aldosterone-producing adenoma (APA) group than in the bilateral adrenal hyperplasia (BAH). Patients with APA had significantly higher left ventricular (LV) mass and A velocity, compared to those with BAH. IL-1β was positively correlated with left atrial volume index. Both TNF-α and MMP-2 also had positive linear correlation with A velocity. Furthermore, MMP-9 showed a positive correlation with LV mass, whereas it was negatively correlated with LV end-systolic diameter.


CONCLUSIONS
These results suggest the possibility that some of inflammatory markers related to oxidative stress may be involved in developing diastolic dysfunction accompanied by LV hypertrophy in PA. Further investigations are needed to clarify the role of oxidative stress in the course of cardiac remodeling.
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.|Institute of Evidence Based Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jung Soo
JS
Lim
Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Sungha
S
Park
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
Sung Il
SI
Park
Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
Young Taik
YT
Oh
Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Eunhee
E
Choi
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Jang Young
JY
Kim
Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea. yumie@yuhs.ac.
Yumie
http://orcid.org/0000-0003-4227-5638
Y
Rhee
Cytokines; Heart diseases; Hyperaldosteronism