Cardiac structural changes in idiopathic hyperaldosteronism and treatment with spironolactone

Objective: To analyze the cardiac structural changes of patients with primary aldosteronism (PA), to observe cardiac structural remodelling of idiopathic hyperaldosteronism (IHA) patients after treatment with spironolactone, and to discuss the association of the remodeling with blood pressure and blood aldosterone levels. Methods: A total of 172 PA patients were taken as experimental group and 100 patients with essential hypertension (EH) served as control group. The clinical data of patients in the two groups were collected. The general information, biochemical data, hormone levels and echocardiographic parameters, including the aortic opening (AO), left atrium diameter (LAd), diastolic left ventricular diameter (DVLd), systolic left ventricular diameter (SVLd), interventricular spetal thickness (IVST), left ventricular posterior wall thickness (LVPW), and left ventricular mass index(LVMI) were compared between the two groups. Thirty-eight patients with IHA were followed up, and changes of the above-mentioned echocardiographic parameters were observed. We also analyzed the relationship between the parameters of cardiac structural remodelling with the blood pressure and plasma aldosterone levels. Results: The AO, LAd, DVLd, SVLd, IVST, LVPW, and LVMI in PA group were significantly increased compared with those in EH group (P<0.01), and these parameters were positively correlated with the systolic pressure (P<0.05). The cardiac hypertrophy parameters, such as IVST and LVMI, were significantly improved after treatment with spironolactone(P< 0.01); and the cardiac volume parameters, such as AO, LAd, DVLd, and SVLd, had no noticeable changes, and were correlated with plasma aldosterone level. Conclusion: PA patients have a more severe cardiac remodeling compared with EH patients, which has a closer relationship with systolic blood pressure. Treatment with spironolactone can ameliorate the cardiac structural changes, especially the cardiac hypertrophy, in IHA patients.