Tanabe A, Naruse M, Naruse K, Hase M, Yoshimoto T, Tanaka M, Seki T, Demura R, Demura H
Department of Medicine, Tokyo Women's Medical College, Japan.
Hypertens Res. 1997 Jun;20(2):85-90. doi: 10.1291/hypres.20.85.
We determined functional and morphological changes of the heart by 2-dimensional and pulse Doppler echocardiography in 20 patients with primary aldosteronism and compared the results with those in 50 healthy normotensive subjects, 12 patients with Cushing's syndrome, 9 patients with pheochromocytoma, and 47 patients with essential hypertension. All hypertensive groups had greater left ventricular mass indexes than did the normotensive group (76.9 +/- 17.2 g/m2). Despite similar age distribution, blood pressure during antihypertensive treatment, and duration of hypertension, the primary aldosteronism group had a significantly greater left ventricular mass index (152.5 +/- 42.5 g/m2) than did the Cushing's syndrome (103.4 +/- 37.5 g/m2), pheochromocytoma (122.4 +/- 28.5 g/m2), and essential hypertension (101.4 +/- 32.8 g/m2) groups. The left ventricular posterior wall thickness and interventricular septal wall thickness were significantly greater in the hypertensive groups than in the normotensive group and also significantly greater in the primary aldosteronism group than in any of the other hypertensive groups. By contrast, there were no significant differences among the four hypertensive groups in any variable of systolic or diastolic function of the heart. The results suggest that left ventricular hypertrophy is more pronounced in patients with primary aldosteronism than in patients with other forms of hypertension. It is therefore important to echocardiographically evaluate cardiac hypertrophy as a risk factor of morbidity and mortality in patients with this low renin hypertension.
我们通过二维和脉冲多普勒超声心动图测定了20例原发性醛固酮增多症患者心脏的功能和形态变化，并将结果与50例健康血压正常者、12例库欣综合征患者、9例嗜铬细胞瘤患者和47例原发性高血压患者进行了比较。所有高血压组的左心室质量指数均高于血压正常组（76.9±17.2g/m²）。尽管年龄分布、降压治疗期间的血压以及高血压病程相似，但原发性醛固酮增多症组的左心室质量指数（152.5±42.5g/m²）显著高于库欣综合征组（103.4±37.5g/m²）、嗜铬细胞瘤组（122.4±28.5g/m²）和原发性高血压组（101.4±32.8g/m²）。高血压组的左心室后壁厚度和室间隔厚度显著高于血压正常组，原发性醛固酮增多症组也显著高于其他任何高血压组。相比之下，四个高血压组在心脏收缩或舒张功能的任何变量上均无显著差异。结果表明，原发性醛固酮增多症患者的左心室肥厚比其他形式高血压患者更为明显。因此，对于这种低肾素性高血压患者，通过超声心动图评估心脏肥厚作为发病和死亡风险因素非常重要。
