Śpiewak Mateusz, Kołodziejczyk-Kruk Sylwia, Kubik Agata, Łebek-Szatańska Agnieszka, Szwench-Pietrasz Elżbieta, Florczak Elżbieta, Januszewicz Magdalena, Januszewicz Andrzej, Marczak Magdalena
Magnetic Resonance Unit, National Institute of Cardiology, 04-628 Warsaw, Poland.
Department of Hypertension, National Institute of Cardiology, 04-628 Warsaw, Poland.
J Clin Med. 2025 Jul 29;14(15):5367. doi: 10.3390/jcm14155367.
While aldosterone excess has a detrimental impact on the left ventricle, no data exist concerning right ventricular (RV) function in primary aldosteronism (PA) patients. We aimed to assess RV structure and function in patients with PA using cardiac magnetic resonance imaging. Thirty PA patients and 30 age- and sex-matched healthy volunteers were studied. All patients underwent cardiac magnetic resonance with the assessment of RV structure and function. Neither the RV mass index (RVMi) nor the RV ejection fraction (RVEF) correlated with the aldosterone levels ( = 0.36 and = 0.37, respectively). On the contrary, we found a weak positive correlation between the RV end-diastolic volume index (RVEDVi) and aldosterone concentration (rho = 0.5, = 0.005). Neither the RVEDVi nor the RVEF differed between the PA patients and the control group ( = 0.077 and = 0.93, respectively). The RVMi was higher in the PA group, at 18.9 (4.9) g/m, versus 13.6 (3.2) g/m (SD) in the control group ( < 0.0001). The RVEDVi was positively correlated with the duration of hypertension (rho = 0.4, = 0.03), and the latter was correlated inversely with the RVEF (rho = -0.47, = 0.009). The RV global longitudinal strain was impaired in PA patients in comparison with the controls (-16.8 (2.5%) versus -19.6 (2.7%), = 0.0001). The PA patients exhibited larger RVMi values than the controls. The higher the aldosterone levels were, the higher the observed RVEDVi. Additionally, the longer the duration of hypertension, the higher the observed RVEDVi and the lower the noted RVEF. The PA patients exhibited subclinical RV systolic dysfunction, expressed as impaired RV global longitudinal strain.
虽然醛固酮过量对左心室有不利影响，但关于原发性醛固酮增多症（PA）患者右心室（RV）功能的数据尚不存在。我们旨在使用心脏磁共振成像评估PA患者的右心室结构和功能。研究了30例PA患者和30名年龄和性别匹配的健康志愿者。所有患者均接受了心脏磁共振检查，以评估右心室结构和功能。右心室质量指数（RVMi）和右心室射血分数（RVEF）均与醛固酮水平无相关性（分别为ρ = 0.36和ρ = 0.37）。相反，我们发现右心室舒张末期容积指数（RVEDVi）与醛固酮浓度之间存在弱正相关（ρ = 0.5，P = 0.005）。PA患者和对照组之间的RVEDVi和RVEF均无差异（分别为P = 0.077和P = 0.93）。PA组的RVMi较高，为18.9（4.9）g/m²，而对照组为13.6（3.2）g/m²（标准差）（P < 0.0001）。RVEDVi与高血压病程呈正相关（ρ = 0.4，P = 0.03），而后者与RVEF呈负相关（ρ = -0.47，P = 0.009）。与对照组相比，PA患者的右心室整体纵向应变受损（-16.8（2.5%）对-19.6（2.7%），P = 0.0001）。PA患者的RVMi值高于对照组。醛固酮水平越高，观察到的RVEDVi越高。此外，高血压病程越长，观察到的RVEDVi越高，而注意到的RVEF越低。PA患者表现出亚临床右心室收缩功能障碍，表现为右心室整体纵向应变受损。
