Liao Che-Wei, Lin Yen-Tin, Wu Xue-Ming, Chang Yi-Yao, Hung Chi-Sheng, Wu Vin-Cent, Wu Kwan-Dun, Lin Yen-Hung
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
Department of Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan.
J Investig Med. 2016 Aug;64(6):1109-13. doi: 10.1136/jim-2015-000014. Epub 2016 May 17.
Primary aldosteronism has been associated with myocardial fibrosis, and is the most common cause of secondary hypertension. We previously showed that aldosterone can induce the secretion of galectin-3. The aim of this study was to investigate the association between myocardial fibrosis and plasma galectin-3 level in patients with primary aldosteronism. We prospectively analyzed 11 patients with aldosterone-producing adenoma (APA) who received adrenalectomy from December 2006 to October 2008, and 17 patients with essential hypertension as controls. Levels of plasma galectin-3 were determined in both groups, and both groups underwent echocardiography with cyclic variations of integrated backscatter (CVIBS) to characterize tissue initially and 1 year after surgery in the APA group. Diastolic blood pressure, concentration of plasma aldosterone and aldosterone-renin ratio were significantly higher, and serum potassium level and plasma renin activity significantly lower in the APA group compared to the controls. In addition, left ventricular mass index was significantly higher and CVIBS significantly lower in the APA group (7.3±2.0 vs 9.2±1.7 dB, p=0.015). Furthermore, the concentration of plasma galectin-3 was significantly higher in the APA group (2.1±0.9 vs 1.1±0.6 ng/mL, p=0.005) compared to the controls. CVIBS was correlated to plasma galectin-3 level. In the APA group, CVIBS increased significantly (7.3±2.0 to 9.2±2.4 dB, p=0.032) and plasma galectin-3 decreased (2.1±0.9 to 1.2±0.6, p=0.049) 1 year postadrenalectomy. The patients with APA had increased myocardial fibrosis, and this was associated with a higher plasma galectin-3 level. Both increased myocardial fibrosis and plasma galectin-3 level recovered at least partially after adrenalectomy.
200611031R; Results.
原发性醛固酮增多症与心肌纤维化有关，是继发性高血压最常见的病因。我们之前表明醛固酮可诱导半乳糖凝集素-3的分泌。本研究的目的是调查原发性醛固酮增多症患者心肌纤维化与血浆半乳糖凝集素-3水平之间的关联。我们前瞻性分析了2006年12月至2008年10月期间接受肾上腺切除术的11例醛固酮瘤（APA）患者，并将17例原发性高血压患者作为对照。测定了两组的血浆半乳糖凝集素-3水平，两组均接受了背向散射积分周期变化（CVIBS）的超声心动图检查，以在初始阶段以及APA组术后1年对组织进行特征描述。与对照组相比，APA组的舒张压、血浆醛固酮浓度和醛固酮-肾素比值显著更高，而血清钾水平和血浆肾素活性显著更低。此外，APA组的左心室质量指数显著更高，CVIBS显著更低（7.3±2.0对9.2±1.7 dB，p = 0.015）。此外，与对照组相比，APA组的血浆半乳糖凝集素-3浓度显著更高（2.1±0.9对1.1±0.6 ng/mL，p = 0.005）。CVIBS与血浆半乳糖凝集素-3水平相关。在APA组中，肾上腺切除术后1年CVIBS显著增加（7.3±2.0至9.2±2.4 dB，p = 0.032），血浆半乳糖凝集素-3降低（2.1±0.9至1.2±0.6，p = 0.049）。APA患者心肌纤维化增加，这与更高的血浆半乳糖凝集素-3水平相关。肾上腺切除术后，心肌纤维化增加和血浆半乳糖凝集素-3水平至少部分恢复。
200611031R；结果。
