Demonstration of Blood Pressure-Independent Noninfarct Myocardial Fibrosis in Primary Aldosteronism A Cardiac Magnetic Resonance Imaging Study
Demonstration of Blood Pressure-Independent Noninfarct Myocardial Fibrosis in Primary Aldosteronism A Cardiac Magnetic Resonance Imaging Study
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DOI：
10.1161/circimaging.112.974576
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发表时间：
2012-11-01
影响因子：
7.5
通讯作者：
Connell, John M. C.
中科院分区：
文献类型：
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作者：
Freel, E. Marie;Mark, Patrick B.;Connell, John M. C.
背景-原发性醛固酮增多症 (PA) 很常见，与心血管疾病发病率过高相关，与血压无关。接触醛固酮和钠会导致人类和动物的心脏纤维化和肥大，这可能是由炎症和氧化应激介导的。我们的目的是使用对比增强心脏磁共振成像阐明醛固酮过量对患有 PA 和原发性高血压的人类受试者心肌结构和组成的影响，并探索任何观察到的差异的机制基础。方法和结果 - 招募了 27 名最近诊断出 PA 的受试者和 54 名原发性高血压对照者。受试者接受钆增强心脏磁共振检查；非梗塞相关的心肌纤维化通过晚期钆增强的弥散模式来识别。患者还接受脉搏波速度评估、循环超氧阴离子和 C 反应蛋白测量，以及血压和生化评估。受试者匹配良好，高血压的严重程度或持续时间没有差异。与原发性高血压受试者（13%；P）相比，PA 中非梗塞晚期钆增强的频率显着增加（70%）
Background-Primary aldosteronism (PA) is common and associates with excess cardiovascular morbidity independent of blood pressure. Exposure to aldosterone and sodium leads to cardiac fibrosis and hypertrophy in humans and animals possibly mediated by inflammation and oxidative stress. We aimed to clarify the effects of aldosterone excess on myocardial structure and composition in human subjects with PA and essential hypertension using contrast-enhanced cardiac magnetic resonance imaging as well as explore the mechanistic basis for any observed differences.Methods and Results-Twenty-seven subjects with recently diagnosed PA and 54 essential hypertension controls were recruited. Subjects underwent gadolinium-enhanced cardiac magnetic resonance; noninfarct related myocardial fibrosis was identified by a diffuse pattern of late gadolinium enhancement. Patients also underwent assessment of pulse wave velocity, measurement of circulating superoxide anion and C-reactive protein, as well as blood pressure and biochemical assessment. Subjects were well matched with no difference in severity or duration of hypertension. There was a significant increase in the frequency of noninfarct late gadolinium enhancement in PA (70%) when compared with essential hypertension subjects (13%; P