https://scholars.lib.ntu.edu.tw/handle/123456789/514815
標題: | Adrenalectomy improves increased carotid intima-media thickness and arterial stiffness in patients with aldosterone producing adenoma | 作者: | YEN-HUNG LIN LIAN-YU LIN Chen A. Wu X.-M. JEN-KUANG LEE TA-CHEN SU VIN-CENT WU SHIH-CHIEH CHUEH WEI-CHOU LIN Lo M.-T. Wang P.-C. YI-LWUN HO KWAN-DUN WU |
公開日期: | 2012 | 卷: | 221 | 期: | 1 | 起(迄)頁: | 154-159 | 來源出版物: | Atherosclerosis | 摘要: | Context: Primary aldosteronism (PA) is the most frequent cause of secondary hypertension, and is associated with more prominent vascular stiffness and atherosclerosis. However, the effect of adrenalectomy on reversibility of vascular damage is unclear. Objective: Our objective was to investigate the vascular changes and possibility of reversibility after adrenalectomy in PA patients. Methods: We prospectively analyzed 20 patients with aldosterone producing adenoma (APA) that received adrenalectomy from October 2006 to December 2008 and 21 patients with essential hypertension (EH) were enrolled as the control group. Carotid intima media thickness (CIMT) measurement by B-mode ultrasound of the right common carotid arteries and pulse wave velocity (PWV) measurement including brachial-ankle PWV (baPWV) and heart-ankle PWV (haPWV) were performed in both groups. The follow-up measurements were performed one-year after adrenalectomy in APA group. Results: APA patients had significantly higher diastolic blood pressure, plasma aldosterone concentration (PAC) and aldosterone-renin ratio (ARR), but lower serum potassium level and plasma renin activity (PRA) than EH patients. APA patients had significantly higher CIMT (0.64 ± 0.13 vs. 0.53 ± 0.10. mm, p= 0.006), higher baPWV (1589 ± 296 vs. 1405 ± 187. cm/s, p= 0.024) and haPWV (1095 ± 150 vs. 987 ± 114. cm/s, p= 0.013) comparing with EH patients. One-year after adrenalectomy, CIMT reduced significantly from 0.64 ± 0.13. mm to 0.59 ± 0.14. mm (p= 0.014), and baPWV and haPWV also showed significant reduction (baPWV, 1589 ± 296 to 1463 ± 188. cm/s, p= 0.035; haPWV, 1095 ± 150 to 1017 ± 109. cm/s, p= 0.019). Conclusion: APA patients have higher degree of early atherosclerosis and vascular stiffness. Adrenalectomy not only corrects the high blood pressure and biochemical parameters but also reverse adverse vascular change in APA patients. ? 2012 Elsevier Ireland Ltd. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84857032755&doi=10.1016%2fj.atherosclerosis.2011.12.003&partnerID=40&md5=fea88a64f500f142494fc773ae22f1d9 https://scholars.lib.ntu.edu.tw/handle/123456789/514815 |
ISSN: | 0021-9150 | DOI: | 10.1016/j.atherosclerosis.2011.12.003 | SDG/關鍵字: | aldosterone; alpha adrenergic receptor blocking agent; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; potassium; renin; spironolactone; thiazide diuretic agent; adenoma; adrenalectomy; adult; aldosterone blood level; aldosterone producing adenoma; aldosterone release; antihypertensive therapy; arterial stiffness; arterial wall thickness; article; B scan; brachial artery; clinical article; common carotid artery; controlled clinical trial; controlled study; diastolic blood pressure; essential hypertension; female; follow up; human; hypertension; male; plasma renin activity; potassium blood level; priority journal; prospective study; pulse wave; systolic blood pressure; treatment response; Adrenal Gland Neoplasms; Adrenalectomy; Adrenocortical Adenoma; Adult; Aldosterone; Analysis of Variance; Ankle Brachial Index; Arteries; Biological Markers; Blood Pressure; Carotid Artery Diseases; Carotid Intima-Media Thickness; Case-Control Studies; Chi-Square Distribution; Elasticity; Female; Hemodynamics; Humans; Hyperaldosteronism; Hypertension; Male; Middle Aged; Potassium; Predictive Value of Tests; Prospective Studies; Pulsatile Flow; Renin; Taiwan; Time Factors; Treatment Outcome |
顯示於: | 醫學系 |
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