From the Divisions of Cardiology (C.C., N.V.) and Endocrinology and Metabolism (S.P., A.T.), Department of Medicine, Medical University of Graz, Graz, Austria; Department of Internal Medicine and Cardiology, Charitè University Medicine, Campus Virchow Klinikum and German Heart Center, Berlin, Germany (E.K.-K., B.P.); and Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy (L.A.S.).
Hypertension. 2015 Jun;65(6):1231-7. doi: 10.1161/HYPERTENSIONAHA.115.05285. Epub 2015 Mar 23.
Aldosterone has hypertrophic and profibrotic effects on the heart. The relationship between plasma aldosterone levels and left ventricular diastolic function in hypertension, however, is unclear. The aim of this study was to examine this relationship in treatment-naïve hypertensive patients free of comorbidities that could affect left ventricular diastolic filling properties. In 115 patients with primary hypertension who were eating a standard diet and 100 matched normotensive controls, we measured plasma aldosterone and active renin levels and performed both conventional echocardiography and tissue-Doppler imaging for assessment of left ventricular diastolic function. Left ventricular hypertrophy was found in 21% of hypertensive patients, and diastolic dysfunction was detected in 20% by conventional echocardiography and in 58% by tissue-Doppler imaging. Patients with left ventricular diastolic dysfunction at tissue-Doppler imaging were older and more frequently men, had greater body mass index, blood pressure, alcohol intake, left ventricular mass index, relative wall thickness, and lower plasma aldosterone levels than patients with preserved diastolic function. Plasma aldosterone correlated directly with left ventricular mass index in addition to age, body mass index, and systolic blood pressure. Plasma aldosterone was also directly related to e' velocity at tissue-Doppler imaging, but this relationship was lost after multivariate adjustment. In conclusion, plasma aldosterone levels are associated with left ventricular hypertrophy but have no independent relationship with left ventricular diastolic properties in hypertensive patients.
醛固酮对心脏有肥厚和致纤维化作用。然而，高血压患者血浆醛固酮水平与左心室舒张功能之间的关系尚不清楚。本研究旨在检查无合并症影响左心室舒张充盈特性的初治高血压患者中这种关系。在 115 名原发性高血压患者（正在食用标准饮食）和 100 名匹配的血压正常对照者中，我们测量了血浆醛固酮和活性肾素水平，并进行了常规超声心动图和组织多普勒成像评估左心室舒张功能。21%的高血压患者存在左心室肥厚，20%的患者通过常规超声心动图、58%的患者通过组织多普勒成像检测到舒张功能障碍。在组织多普勒成像上存在左心室舒张功能障碍的患者年龄较大，且更常见为男性，体重指数、血压、饮酒量、左心室质量指数、相对壁厚度更高，血浆醛固酮水平更低。除年龄、体重指数和收缩压外，血浆醛固酮与左心室质量指数直接相关。血浆醛固酮与组织多普勒成像上的 e'速度也直接相关，但这种关系在多变量调整后消失。总之，在高血压患者中，血浆醛固酮水平与左心室肥厚有关，但与左心室舒张功能无独立关系。
