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The Relation Between the Degree of Left Ventricular Mass Regression and Serum Potassium Level Change in Patients With Primary Aldosteronism After Adrenalectomy
  1. Che-Wei Liao, MD*,,
  2. Aaron Chen, MD,
  3. Yen-Tin Lin, MD*,
  4. Yi-Yao Chang, MD§,
  5. Shuo-Meng Wang, MD, PhD,
  6. Vin-Cent Wu, MD, PhD*,
  7. Chi-Sheng Hung, MD*,
  8. Kwan-Dun Wu, MD, PhD*,
  9. Shih-Chieh Chueh, MD, PhD,
  10. Yen-Hung Lin, MD, PhD*
  1. From the *Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei; †Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; ‡Woodhull Medical and Mental Hospital, Brooklyn, NY; §Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City; ∥Department of Urology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; and ¶Department of Urology, Cleveland Clinic, Cleveland, OH.
  1. Received March 3, 2015, and in revised form April 23, 2015.
  2. Accepted for publication April 26, 2015.
  3. Supported by the National Taiwan University Hospital (NTUH 102-S2096, NTUH 103-M254, NTUH 103-S2447, NTUH 103-S2347), National Taiwan University (UN102-060), and Taiwan National Science Council (NSC 102-2314-B-002-056, NSC 102-2314-B-002-078-MY3).
  4. Reprints: Yen-Hung Lin, MD, PhD, Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Rd, Taipei, Taiwan. E-mail: austinr34{at}gmail.com.

Abstract

Background Primary aldosteronism (PA) is one of the major etiologies for secondary hypertension featuring more prominent left ventricular hypertrophy. The purpose of the study was to investigate the predictive factors of left ventricular mass index (LVMI) regression in patients with PA after adrenalectomy.

Methods We prospectively analyzed 30 patients with aldosterone-producing adenoma (APA) who received adrenalectomy from October 2006 to September 2008. Echocardiography was performed preoperation and 1 year after operation.

Results Thirty patients with aldosterone-producing adenoma undergoing adrenalectomy were enrolled. In a 1-year follow-up, LVMI decreased significantly by an average of 18.6%. Net LVMI decrease (ΔLVMI) was associated with preoperative LVMI, preoperative serum potassium level, baseline systolic blood pressure (SBP), baseline diastolic blood pressure, net SBP decrease (ΔSBP), net diastolic blood pressure decrease, preoperative/postoperative change of log-transformed plasma aldosterone concentration, preoperative/postoperative change of log-transformed plasma renin activity, and preoperative/postoperative change of serum potassium level (Δserum potassium level). In a multiple regression analysis, preoperative LVMI (β = −0.287, P = 0.049), ΔSBP (β = 0.518, P = 0.01), and Δserum potassium level (β = −20.471, P = 0.014) were significantly correlated with ΔLVMI.

Conclusions The LVMI in patients with PA regressed significantly after adrenalectomy. Preoperative LVMI, ΔSBP, and Δserum potassium levels are independent factors associated with the degree of LVMI regression.

Key Words
  • adrenalectomy
  • aldosteronism
  • left ventricular hypertrophy
  • potassium

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