AUTHOR=Curione Mario , Petramala Luigi , Savoriti Claudio , Verrenti Marisa , Baiocco Erika , Salvatore Stephanie , Zinnamosca Laura , Iannucci Gino , Sciomer Susanna , Letizia Claudio
TITLE=Electrical and Myocardial Remodeling in Primary Aldosteronism
JOURNAL=Frontiers in Cardiovascular Medicine
VOLUME=1
YEAR=2014
URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2014.00007
DOI=10.3389/fcvm.2014.00007
ISSN=2297-055X
ABSTRACT=Objective and design: 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 (χ2, p < 0.03).
Conclusion: 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.