scholarly journals MON-213 Cardiac Damage and Related Risk Factors in Patients with Primary Aldosteronism

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
wei wang
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Essential Hypertension ◽  
Primary Aldosteronism ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Left Ventricular ◽  
Cardiac Damage ◽  
Course Of Disease ◽  
Related Risk

Abstract Primary aldosteronism (PA) is the most common cause of secondary hypertension. Overseas flow surveys show that compared with essential hypertension (EH), the risk of cardiovascular and cerebrovascular diseases and kidney damages in PA patients is increased, and the mortality rate of cardiovascular events is higher than that in EH patients, in addition,this effect is independent of elevated blood pressure. The difference of cardiac damage between PA and EH patients was analyzed by echocardiography. Methods From April 28, 2017 to April 28, 2019, patients with primary aldosteronism diagnosed by ICD in Department of Endocrinology and Metabolism, Department of Cardiology and Urology were extracted from the adrenal group database of the Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, and ICD diagnosis in Department of Endocrinology and Metabolism during the same period was also extracted. In patients with essential hypertension, the differences of clinical indicators and echocardiography between the two groups were compared, and the differences of cardiac damage and related risk factors between the two groups were explored. Results 295 patients were included in this study, including 148 patients in PA group (50.17%) and 147 patients in EH group (49.83%). There was no significant difference in gender, age, BMI, course of disease and average blood pressure between the two groups (P > 0.05). The levels of serum aldosterone and BNP in PA group were significantly higher than those in EH group, and the levels of serum renin and minimum blood potassium were significantly lower than those in EH group (P < 0.05). Left ventricular diameter (LV), left atrial diameter (LA), interventricular septal thickness (IVS), left ventricular posterior wall thickness (LVPW), ascending aorta diameter (AAO), end-diastolic diameter (EDD), end-diastolic volume (EDV) and stroke volume (SV) in PA group were significantly higher than those in EH group (P < 0.05). It was significantly higher than that in EH group (P < 0.05). The correlation analysis of variables with statistical significance between the two groups showed that serum renin activity level was negatively correlated with LV, AAO, EDD and SV, and the lowest serum potassium level was negatively correlated with LVPW and AAO. CONCLUSION Compared with EH of the same age, course of disease and blood pressure level, PA patients are more likely to suffer from cardiac damage, which is manifested by heart growth, ventricular septal thickening and cardiac function decline, and is closely related to the inhibition of serum renin activity and serum potassium level. Clinical attention should be paid to early screening and treatment of PA and its complications in order to reduce the risk of cardiac death.Key words: primary aldosteronism; echocardiography; cardiovascular risk factors

scholarly journals Vitamin D and subclinical cardiac damage in a cohort of kidney transplanted patients: a retrospective observational study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
C. Alfieri ◽  
S. Vettoretti ◽  
O. Ruzhytska ◽  
M. T. Gandolfo ◽  
D. Cresseri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Vitamin D ◽  
Ventricular Hypertrophy ◽  
Hypovitaminosis D ◽  
Left Ventricular ◽  
Cardiac Damage ◽  
Lower Serum ◽  
Instrumental Data ◽  
Dialysis Vintage

Abstract In 178-kidney transplanted patients (KTxp), the prevalence of hypovitaminosis-D, the presence and novel development of left ventricular hypertrophy(LVH) and the correlations between native Vitamin-D (25OHD) and LVH were evaluated during the 1st year of transplantation (KTx). Clinical and instrumental data were recorded at pre-KTx and at one (T1) and 12 (T12) months after KTx. 25OHD levels were considered sufficient (s25OHD, ≥ 30 ng/dL) or insufficient (i25OHD, < 30 ng/dL). 25OHD correlated at T1 with parathormone(PTH), and at T12 with 25OHD-T1 and PTH-(T1,T12). At T12, s25OHD (15%) had higher 25OH and alkaline phosphatase (ALP), lower Ca, at T1, and lower PTH-(T1, T12) than i25OH-T12. At T1, KTxp with LVH (LVH-T1pos, 42%) were older and with longer dialysis vintage than LVH-T1neg. At T12, KTxp with LVH (LVH-T12pos, 53%) were older, with higher systolic blood pressure (SBP) at T12 than LVH-T12neg. No relation between 25OHD and LVH were found. Novel LVH was found in 14% of KTxp. They were older, had higher SBP-T12 and lower serum albumin-T12 than the others. LVH-modifications and 25OHD were not correlated. Hypovitaminosis-D is highly prevalent in KTxp. LVH correlates with different risk factors according to the time elapsed from KTx. However, during the 1st year of KTx, no relationship between LVH and 25OHD was observed.

scholarly journals The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension

2020 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Variability ◽  
Target Organ Damage ◽  
Plasma Renin ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Renin Angiotensin

Abstract Background To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension. Methods A case-control study was conducted on 132 children diagnosed with essential hypertension(103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20． Results Among the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P= 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [ β± s.e.= 0.025±0.006, 95% CI ( 0.013–0.038), P = 0.0001] and aldosterone [ β± s.e.= 0.021±0.007, 95% CI( 0.008–0.034), P = 0.002] were risk factors for LVH. Conclusions The AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension.

scholarly journals CMR-Verified Myocardial Fibrosis Is Associated With Subclinical Diastolic Dysfunction in Primary Aldosteronism Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Fangli Zhou ◽  
Tao Wu ◽  
Wei Wang ◽  
Wei Cheng ◽  
Shuang Wan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Diastolic Dysfunction ◽  
Myocardial Fibrosis ◽  
Primary Aldosteronism ◽  
Cardiac Fibrosis ◽  
Left Ventricular ◽  
Diffuse Myocardial Fibrosis ◽  
Clinical Trial Registration ◽  
Plasma Aldosterone Concentration

ObjectivesThe main cardiac features of primary aldosteronism (PA) are impaired left ventricular (LV) diastolic function, and some articles also reported more cardiac fibrosis in PA patients. However, the correlation between LV dysfunction and diffuse myocardial fibrosis in PA remains unknown.MethodsWe enrolled 84 PA patients and 28 essential hypertension (EH) patients in West China Hospital. Cardiac magnetic resonance imaging (CMR) contrast enhancement was arranged for all subjects. Postcontrast T1 time and left ventricular myocardial strains and strain rates were measured.Results76 PA patients and 27 essential hypertension (EH) patients were included in the final analysis. Blood pressure, LV mass indexes, and LV ejection fractions were comparable in both groups, while the global circumferential peak diastolic strain rate (PDSR) was lower (0.9 ± 0.3 vs. 1.1 ± 0.4, p &lt;0.01) and the postcontrast T1 time was shorter (520 ± 38 vs. 538 ± 27, p = 0.01) in PA patients than those in EH patients. Postcontrast T1 time (p = 0.01) was independently related to global circumferential PDSR after adjusting for age and duration of hypertension in PA patients. Furthermore, plasma aldosterone concentration was negatively associated with postcontrast T1 time (R = −0.253, p = 0.028) in PA patients.ConclusionsThe global circumferential PDSR derived by CMR is decreased, and the diffuse myocardial fibrosis is increased in PA patients compared to those in blood pressure matched EH patients. The severity of cardiac diastolic dysfunction independently relates to the degree of diffuse myocardial fibrosis in PA patients, and the diffuse myocardial fibrosis may be caused by high PAC level.Clinical Trial Registrationhttp://www.chictr.org.cn/listbycreater.asp, identifier ChiCTR2000031792.

scholarly journals The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension

2020 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Variability ◽  
Target Organ Damage ◽  
Plasma Renin ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Renin Angiotensin

Abstract Background To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension. Methods A case-control study was conducted on 132 children diagnosed with essential hypertension(103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20． Results Among the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P= 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [ β± s.e.= 0.025±0.006, 95% CI ( 0.013–0.038), P = 0.0001] and aldosterone [ β± s.e.= 0.021±0.007, 95% CI( 0.008–0.034), P = 0.002] were risk factors for LVH. Conclusions The AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension. Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system

scholarly journals The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension

2019 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Plasma Renin ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Cardiac Damage ◽  
Renin Angiotensin

Abstract Background To investigate the relationships of plasma RAAS levels to BPV and TOD in children with essential hypertension.Methods A case-control study was conducted on 132 children diagnosed with essential hypertension, comprising 103 males and 29 females with the mean age of 11.8 ± 2.4 years. The plasma RAAS levels were measured by enhanced chemiluminescence method, and the ambulatory blood pressure was monitored for 24h, followed by calculation of the coefficients of variability (CV). Data on indicators for assessing fundus, cardiac, and renal damages. The correlations of plasma RAAS levels to BPV and TOD were studied. Comparison between groups was analyzed by SPSS 20．Results Among the 132 children, 88 cases had target organ damage. The daytime CV of systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.365, P = 0.019). Plasma AT II and aldosterone levels were significantly associated with left ventricular mass index (r = 0.316, P < 0.01; r = 0.176, P = 0.043), and plasma AT II was positively correlated with the LVMI (r = 0.316; P < 0.01).Conclusions The AT II level in children with essential hypertension affected the variability of daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage, especially the AT II. Results from this study provide an objective basis for the protection against subclinical cardiac damage in childhood hypertension.Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system

scholarly journals CMR-Verified Myocardial Fibrosis is Associated With Subclinical Diastolic Dysfunction in Primary Aldosteronism Patients

2021 ◽  
Author(s):  
Fangli Zhou ◽  
Tao Wu ◽  
Wei Wang ◽  
Wei Cheng ◽  
Shuang Wan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Diastolic Dysfunction ◽  
Myocardial Fibrosis ◽  
Primary Aldosteronism ◽  
Cardiac Fibrosis ◽  
Final Analysis ◽  
Left Ventricular ◽  
Diffuse Myocardial Fibrosis ◽  
Plasma Aldosterone Concentration

Abstract The main cardiac features of primary aldosteronism (PA) are impaired left ventricular (LV) diastolic function, and some articles also reported more cardiac fibrosis in PA patients. However, the correlation between LV dysfunction and diffuse myocardial fibrosis in PA remains unknown. We enrolled 84 PA patients and 28 essential hypertension (EH) patients in West China Hospital. Cardiac magnetic resonance imaging (CMR) contrast enhancement was arranged for all subjects. Postcontrast T1 time and left ventricular myocardial strains and strain rates were measured. 76 PA patients and 27 essential hypertension (EH) patients were included in the final analysis. Blood pressure, LV mass indexes, and LV ejection fractions were comparable in both groups, while the global circumferential peak diastolic strain rate (PDSR) was lower (53 ± 20 vs. 68 ± 25, p<0.01) and the postcontrast T1 time was shorter (520 ± 38 vs. 538 ± 27, p=0.01) in PA patients than those in EH patients. Postcontrast T1 time (p=0.01) was independently related to global circumferential PDSR after adjusting for age and duration of hypertension in PA patients. Furthermore, plasma aldosterone concentration was negatively associated with myocardial T1 time (R=-0.261, p=0.023) in PA patients. The global circumferential PDSR derived by CMR is decreased, and the diffuse myocardial fibrosis is increased in PA patients compared to those in blood pressure matched EH patients. The severity of cardiac diastolic dysfunction independently relates to the degree of diffuse myocardial fibrosis in PA patients, and the diffuse myocardial fibrosis may be caused by high PAC level. Trial registration number: ChiCTR2000031792.

Increased monocyte to HDL cholesterol ratio in vitamin B12 deficiency: is it related to cardiometabolic risk?

2020 ◽  
pp. 1-8
Author(s):  
Sanem Kayhan ◽  
Nazli Gulsoy Kirnap ◽  
Mercan Tastemur
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Uric Acid ◽  
Vitamin B12 ◽  
Cardiometabolic Risk ◽  
Vitamin B12 Deficiency ◽  
Left Ventricular ◽  
Cardiometabolic Risk Factors ◽  
B12 Deficiency ◽  
Deficiency Group

Abstract. Vitamin B12 deficiency may have indirect cardiovascular effects in addition to hematological and neuropsychiatric symptoms. It was shown that the monocyte count-to-high density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel cardiovascular marker. In this study, the aim was to evaluate whether MHR was high in patients with vitamin B12 deficiency and its relationship with cardiometabolic risk factors. The study included 128 patients diagnosed with vitamin B12 deficiency and 93 healthy controls. Patients with vitamin B12 deficiency had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), MHR, C-reactive protein (CRP) and uric acid levels compared with the controls (median 139 vs 115 mmHg, p < 0.001; 80 vs 70 mmHg, p < 0.001; 14.2 vs 9.5, p < 0.001; 10.2 vs 4 mg/dl p < 0.001; 6.68 vs 4.8 mg/dl, p < 0.001 respectively). The prevalence of left ventricular hypertrophy was higher in vitamin B12 deficiency group (43.8%) than the control group (8.6%) (p < 0.001). In vitamin B12 deficiency group, a positive correlation was detected between MHR and SBP, CRP and uric acid (p < 0.001 r:0.34, p < 0.001 r:0.30, p < 0.001 r:0.5, respectively) and a significant negative correlation was detected between MHR and T-CHOL, LDL, HDL and B12 (p < 0.001 r: −0.39, p < 0.001 r: −0.34, p < 0.001 r: −0.57, p < 0.04 r: −0.17, respectively). MHR was high in vitamin B12 deficiency group, and correlated with the cardiometabolic risk factors in this group, which were SBP, CRP, uric acid and HDL. In conclusion, MRH, which can be easily calculated in clinical practice, can be a useful marker to assess cardiovascular risk in patients with vitamin B12 deficiency.

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