https://scholars.lib.ntu.edu.tw/handle/123456789/553056
標題: | KCNJ5 Somatic Mutations in Aldosterone-Producing Adenoma Are Associated With a Worse Baseline Status and Better Recovery of Left Ventricular Remodeling and Diastolic Function | 作者: | Chang, Yi-Yao CHENG-HSUAN TSAI Peng, Shih-Yuan ZHENG-WEI CHEN CHIN-CHEN CHANG BO-CHING LEE CHE-WEI LIAO CHIEN-TING PAN Chen, Ya-Li Lin, Lung-Chun Yi-Ru Chang Kang-Yung Peng Chia-Hung Chou VIN-CENT WU CHI-SHENG HUNG YEN-HUNG LIN |
關鍵字: | adenoma; adrenalectomy; blood pressure; body mass index; propensity score | 公開日期: | 一月-2021 | 卷: | 77 | 期: | 1 | 來源出版物: | Hypertension (Dallas, Tex. : 1979) | 摘要: | Primary aldosteronism is the most common secondary endocrine form of hypertension and causes many cardiovascular injuries. KCNJ5 somatic mutations have recently been identified in aldosterone-producing adenoma. However, their impacts on left ventricular remodeling precluding the interference of age, sex, and blood pressure are still uncertain. We enrolled 184 aldosterone-producing adenoma patients who received adrenalectomy. Clinical, biochemical, and echocardiographic data were analyzed preoperatively and 1 year postoperatively. KCNJ5 gene sequencing of aldosterone-producing adenoma was performed. After propensity score matching for age, sex, body mass index, blood pressure, hypertension duration, and number of hypertensive medications, there were 60 patients in each group with and without KCNJ5 mutations. The mutation carriers had higher left ventricular mass index (LVMI) and inappropriately excessive LVMI (ieLVMI) and lower e' than the noncarriers. After adrenalectomy, the mutation carriers had greater decreases in LVMI and ieLVMI than the noncarriers. In addition, only mutation carriers had a significant decrease in E/e' after surgery. In multivariate analysis, baseline LVMI correlated with KCNJ5 mutations, the number of hypertensive medications, and systolic blood pressure. Baseline ieLVMI correlated with KCNJ5 mutations and the number of hypertensive medications. The regression of both LVMI and ieLVMI after surgery was mainly correlated with KCNJ5 mutations and changes in systolic blood pressure. Aldosterone-producing adenoma patients with KCNJ5 mutations had higher LVMI and ieLVMI and a greater regression of LVMI and ieLVMI after adrenalectomy than those without mutations. The patients with KCNJ5 mutations also benefited from adrenalectomy with regard to left ventricular diastolic function, whereas noncarriers did not. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/553056 | ISSN: | 0194911X | DOI: | 10.1161/HYPERTENSIONAHA.120.15679 |
顯示於: | 法醫學科所 |
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