Matsumoto Takeshi, Oki Kenji, Kajikawa Masato, Nakashima Ayumu, Maruhashi Tatsuya, Iwamoto Yumiko, Iwamoto Akimichi, Oda Nozomu, Hidaka Takayuki, Kihara Yasuki, Kohno Nobuoki, Chayama Kazuaki, Goto Chikara, Aibara Yoshiki, Noma Kensuke, Liao James K, Higashi Yukihito
From the Departments of Cardiovascular Medicine (T. Matsumoto, M.K., T. Maruhashi, Y.I., A.I., N.O., T.H., Y.K.) and Molecular and Internal Medicine (K.O., N.K.), Graduate School of Biomedical and Health Sciences, Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences (K.C.), and Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine (Y.A., K.N., Y.H.), Hiroshima University, Hiroshima, Japan; Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan (A.N., Y.H.); Department of Physical Therapy, Hiroshima International University, Hiroshima, Japan (C.G.); and Section of Cardiology, University of Chicago Medical Center, IL (J.K.L.).
Hypertension. 2015 Apr;65(4):841-8. doi: 10.1161/HYPERTENSIONAHA.114.05001. Epub 2015 Jan 26.
The purpose of this study was to evaluate vascular function and activity of Rho-associated kinases (ROCKs) in patients with primary aldosteronism. Vascular function, including flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation, and ROCK activity in peripheral leukocytes were evaluated in 21 patients with aldosterone-producing adenoma (APA), 23 patients with idiopathic hyperaldosteronism (IHA), and 40 age-, sex-, and blood pressure-matched patients with essential hypertension (EHT). FMD was significantly lower in the APA group than in the IHA and EHT groups (3.2±2.0% versus 4.6±2.3% and 4.4±2.2%; P<0.05, respectively), whereas there was no significant difference in FMD between the IHA and EHT groups. There was no significant difference in nitroglycerine-induced vasodilation in the 3 groups. ROCK activity was higher in the APA group than in the IHA and EHT groups (1.29±0.57 versus 1.00±0.46 and 0.81±0.36l; P<0.05, respectively), whereas there was no significant difference in ROCK activity between the IHA and EHT groups. FMD correlated with age (r=-0.31; P<0.01), plasma aldosterone concentration (r=-0.35; P<0.01), and aldosterone:renin ratio (r=-0.34; P<0.01). ROCK activity correlated with age (r=-0.24; P=0.04), plasma aldosterone concentration (r=0.33; P<0.01), and aldosterone:renin ratio (r=0.46; P<0.01). After adrenalectomy, FMD and ROCK activity were restored in patients with APA. APA was associated with both endothelial dysfunction and increased ROCK activity compared with those in IHA and EHT. APA may have a higher risk of future cardiovascular events.
本研究的目的是评估原发性醛固酮增多症患者的血管功能和Rho相关激酶（ROCKs）的活性。对21例醛固酮瘤（APA）患者、23例特发性醛固酮增多症（IHA）患者以及40例年龄、性别和血压匹配的原发性高血压（EHT）患者，评估其血管功能，包括血流介导的血管舒张（FMD）和硝酸甘油诱导的血管舒张，以及外周血白细胞中的ROCK活性。APA组的FMD显著低于IHA组和EHT组（分别为3.2±2.0% 对 4.6±2.3% 和 4.4±2.2%；P<0.05），而IHA组和EHT组之间的FMD无显著差异。3组患者硝酸甘油诱导的血管舒张无显著差异。APA组的ROCK活性高于IHA组和EHT组（分别为1.29±0.57 对 1.00±0.46 和 0.81±0.36；P<0.05），而IHA组和EHT组之间的ROCK活性无显著差异。FMD与年龄（r=-0.31；P<0.01）、血浆醛固酮浓度（r=-0.35；P<0.01）以及醛固酮：肾素比值（r=-0.34；P<0.01）相关。ROCK活性与年龄（r=-0.24；P=0.04）、血浆醛固酮浓度（r=0.33；P<0.01）以及醛固酮：肾素比值（r=0.46；P<0.01）相关。肾上腺切除术后，APA患者的FMD和ROCK活性恢复。与IHA和EHT相比，APA与内皮功能障碍和ROCK活性增加均相关。APA未来发生心血管事件的风险可能更高。
