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ȣ - 550069 358 |
| Serum Aldosterone and its Relationship to Left Ventricular Geometry and Function in Young Adults with Never Treated Hypertension: Assessed by 2-Dimensional Speckled Tracking Imaging Study |
| 고려의대 안암병원 |
| 박성미, 오웅진, 김정향, 최영운, 김미나, 김용현, 심완주 |
Background: Aldosterone is associated with myocardial fibrosis and left ventricular (LV) remodeling. We aimed to evaluate the relationship of aldosterone and aldosterone-to-renin ratio (ARR) to LV geometry and function in young patients with never treated hypertension (HT).
Methods: Consecutive 75 young patients with never treated primary HT and 45 normal controls were enrolled. Two dimensional strain imaging was performed and LV global longitudinal, radial, and circumferential peak strain (GLS, GRS and GCS, respectively) and twist were measured. Serum aldosterone concentration (SAC) and plasma renin activity (PRA) were obtained in HT patients. ARR was calculated as SAC divided by PRA. LV geometry was classified by LV mass index (LVMI) and relative wall thickness (RWT).
Results: HT patients had higher LVMI and RWT, but lower GLS, GCS and twist than normal controls. SAC correlated with both LVMI (r=0.483, p<0.001) and RWT (r=0.368, p=0.005). Both SAC and ARR were higher in patients with any LV hypertrophy (LVH) than patients with normal geometry, but only SAC was higher in patients with concentric LVH than patients with eccentric LVH. GLS and GCS were significantly low and LV twist was significantly high in patients with concentric LVH than other HT patients (Table). SAC was negatively related to GLS and GCS (r=-0.288, p=0.03 and r=-0.385, p=0.004) and was most related to GCS.
Conclusion: High SAC was related to an increase in LVMI and concentric LVH and to decreases in GLS and GCS. Our findings may indicate the pro-hypertrophic and myocardial fibrosis effect of aldosterone is a key role for the changes of LV geometry and function in young patients with never treated HT.
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Geometry in HT patients |
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Normal control (n=45) |
HT patients (n=75) |
p-value |
Normal geometry
(n=50) |
Eccentric LVH (n=10) |
Concentric LVH (n=15) |
p-value
(ANOVA) |
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Age, years |
28.9±5.1 |
30.3±7.0 |
0.25 |
29.8±6.2 |
31.4±5.5 |
30.9±10.9 |
0.43 |
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LVEF, % |
61.6±5.7 |
61.9±6.6 |
0.86 |
61.9±5.4 |
61.7±9.2 |
63.5±7.3 |
0.79 |
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RWT |
0.33±0.04 |
0.40±0.09 |
<0.001 |
0.35±0.04 |
0.36±0.03 |
0.53±0.07 |
<0.001 |
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LVMI, g/m2 |
80.0±12.7 |
101.5±16.3 |
<0.001 |
80.3±12.2 |
115.0±12.1 |
131.7±15.3 |
<0.001 |
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GLS, % |
-20.0±2.4 |
-17.9±2.9 |
<0.001 |
-18.5±2.7* |
-17.5±2.7 |
-15.9±2.8 |
0.03 |
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GRS, % |
40.4±8.8 |
41.2±8.0 |
0.62 |
41.4±7.6 |
39.4±7.8 |
44.1±8.8† |
0.44 |
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GCS, % |
-21.8±2.9 |
-20.1±3.5 |
0.009 |
-20.5±3.3 |
-20.3±3.3 |
-18.6±3.0†‡ |
0.30 |
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Twist, ° |
18.3±4.7 |
21.6±5.7 |
0.002 |
21.4±4.9* |
21.1±3.5 |
25.2±3.8 |
0.03 |
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SAC, pg/mL |
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64.2±26.9 |
115.9±25.4 |
153.5±21.9 |
<0.001 |
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PRA, ng/mL/hr |
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2.68±2.43 |
2.79±1.55 |
3.62±1.41 |
0.48 |
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ARR |
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34.0±19.5 |
46.0±20.1 |
51.6±24.4‡ |
0.08 |
*P<0.05, Normal control vs Normal geometry
†p<0.05, Eccentric LVH vs Concentric LVH
‡p<0.05, Normal geometry vs Concentric LVH
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