In:
Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 40, No. 6 ( 2022-06), p. 1204-1211
Abstract:
We compared persistent cardiac organ damage in patients treated surgically or medically for primary aldosteronism. Methods: Eighty-four patients (age 57 ± 11 years, 27% women) with primary aldosteronism underwent echocardiography at time of diagnosis and after one year of treatment (49% adrenalectomy, 51% medical treatment). Persistent cardiac organ damage was defined as presence of left ventricle (LV) hypertrophy, low LV midwall shortening, global longitudinal strain and/or enlarged left atrium both at baseline and at follow-up. Results: At one year, a significant regression of LV hypertrophy was observed in surgically (44 vs. 22%, P = 0.039), but not in medically treated patients (60 vs. 51%, P = 0.206). The prevalence of enlarged left atrium was reduced in both groups (both P 〈 0.001), whereas systolic myocardial function remained unchanged. In multivariable logistic regression analysis, medical treatment [odds ratio (OR) 4.88 (95% confidence interval (CI) 1.26–18.88)] was a strong predictor of persistent LV hypertrophy independent of higher BMI [OR 1.20 (95% CI 1.04–1.38)] and presence of diabetes [OR 6.48 (95% CI 1.20–34.83), all P 〈 0.05]. Persistently low midwall shortening was associated with suppressed plasma renin after one year [OR 6.11 (95% CI 1.39–26.7)] and lower renal function [OR 0.96 (95% CI 0.94–0.99), both P 〈 0.05]. The strongest predictor of persistently low global longitudinal strain was higher HbA 1c [OR 2.37 (95% CI 1.12–5.02), P = 0.024]. Conclusion: Persistent cardiac organ damage was more common in the medical treatment group and associated with incomplete aldosterone blockade, impaired renal function and presence of metabolic comorbidities. Graphical abstract: http://links.lww.com/HJH/B925.
Type of Medium:
Online Resource
ISSN:
0263-6352
,
1473-5598
DOI:
10.1097/HJH.0000000000003135
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2017684-3
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