Adrenalectomy reverses myocardial fibrosis in patients with primary aldosteronism

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题名:	Adrenalectomy reverses myocardial fibrosis in patients with primary aldosteronism
作者:	羅孟宗;Lin, Yen-Hung;Wu, Xue-Ming;Lee, Hsiu-Hao;Lee, Jen-Kuang;Liu, Yu-Chun;Chang, Hung-Wei;Lin, Chien-Yu;Wu, Vin-Cent;Chueh, Shih-Chieh;Lin, Lung-Chun;Lo, Men-Tzung;Ho, Yi-Lwun;Wu, Kwan-Dun
贡献者:	生醫理工學院生醫科學與工程學系
关键词:	Adenoma - complications;Adenoma - pathology;Adenoma - surgery;Adrenal Gland Neoplasms - complications;Adrenal Gland Neoplasms - pathology;Adrenal Gland Neoplasms - surgery;Adrenalectomy;Aldosterone - blood;Cardiomyopathies - diagnosis;Cardiomyopathies - etiology;Cardiomyopathies - prevention & control;Echocardiography;Female;Fibrosis - prevention & control;Humans;Hyperaldosteronism - blood;Hyperaldosteronism - complications;Hyperaldosteronism - diagnosis;Hyperaldosteronism - surgery;Hypertension - etiology;Hypertension - pathology;Hypertension - physiopathology;Hypertrophy, Left Ventricular - diagnosis;Hypertrophy, Left Ventricular - etiology;Hypertrophy, Left Ventricular - prevention & control;Male;Middle Aged;Myocardium - pathology;Peptide Fragments;Potassium - blood;Procollagen;Prospective Studies;Renin - blood;Treatment Outcome
日期:	2012-01-01
上传时间:	2026-04-23 11:14:58 (UTC+8)
出版者:	Lippincott Williams and Wilkins Ltd.;England: Lippincott Williams & Wilkins, Inc
摘要:	摘要： OBJECTIVE:Primary aldosteronism is the most frequent cause of secondary hypertension and is associated with more prominent left ventricular hypertrophy and increased myocardial fibrosis. However, the reversibility of cardiac fibrosis is still unclear. Our objective was to investigate myocardial fibrosis in primary aldosteronism patients and its change after surgery. METHOD:We prospectively analyzed 20 patients with aldosterone-producing adenoma (APA) who received adrenalectomy from December 2006 to October 2008 and 20 patients with essential hypertension were enrolled as the control group. Plasma carboxy-terminal propeptide of procollagen type I (PICP) determination and echocardiography including ultrasonic tissue characterization by cyclic variation of integrated backscatter (CVIBS) were performed in both groups and 1 year after operation in the APA group. RESULTS:APA patients had significantly higher SBP and DBP, higher plasma aldosterone concentration (PAC), higher aldosterone–renin ratio (ARR), lower serum potassium levels, and lower plasma renin activity (PRA) than patients with essential hypertension. In echocardiography, APA patients had a higher left ventricular mass index than essential hypertension patients. APA patients had significantly lower CVIBS (6.2 ± 1.5 vs. 8.7 ± 2.0 dB, P < 0.001) and higher plasma PICP levels (107 ± 27 vs. 85 ± 24 μg/l, P = 0.009) than essential hypertension patients. In the correlation study, CVIBS is correlated with log-transformed PRA and log-transformed ARR and PICP is correlated with log-transformed PRA, log-transformed PAC, and log-transformed ARR. One year after adrenalectomy, CVIBS increased significantly (6.2 ± 1.5 to 7.3 ± 1.7 dB, P = 0.033) and plasma PICP levels decreased (107 ± 27 vs. 84 ± 28 μg/l, P = 0.026). CONCLUSION:Increases in collagen content in the myocardium of APA patients may be reversed by adrenalectomy. 其他題名： J Hypertens 出版者： England: Lippincott Williams & Wilkins, Inc 出版日期： 2012-08 出處： Journal of hypertension, 2012-08, Vol.30 (8), p.1606-1613 版權： 2012 Lippincott Williams & Wilkins, Inc. 識別號： ISSN: 0263-6352 識別號： ISSN: 1473-5598 識別號： EISSN: 1473-5598 識別號： DOI: 10.1097/HJH.0b013e3283550f93 識別號： PMID: 22688266
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