U-shaped relationship between left ventricular mass index and estimated glomerular filtration rate in patients with primary aldosteronism
Journal
Journal of Investigative Medicine
Journal Volume
68
Journal Issue
2
Pages
371
Date Issued
2020-02-01
Author(s)
Chang, Yi-Yao
Kuo, Shu-Fen
Wu, Xue-Ming
Abstract
Estimated glomerular filtration rate (eGFR) is an important topic in patients with primary aldosteronism (PA). However, the relationship between left ventricular structure and eGFR is unclear. We conducted a prospective, observational, and cross-sectional study to analyze 168 patients with PA and 168 propensity score-matched patients with essential hypertension (EH) as the control group, matched by age, gender, and systolic blood pressure. In the patients with PA, the eGFR was not correlated with left ventricular mass index (LVMI; r=-0.065, p=0.404), while in the patients with EH, the eGFR was negatively correlated with LVMI (r=-0.309, p<0.001). To test whether eGFR had a non-linear relationship with LVMI among the patients with PA, we stratified the patients with PA according to the tertile of eGFR (low, medium, and high tertile). The medium tertile of patients had a significantly lower LVMI than those in the other two tertiles (LVMI: 143.5±41.6, 120.5±40.5, and 133.1±34.3 g/m 2, from the lowest to highest tertile of eGFR; analysis of covariance p=0.032). The medium tertile of eGFR is associated with lowest LVMI. Patients with PA with high and low eGFR were associated with higher LVMI. The findings implied that the reasons for an increased LVMI in patients with PA may be different to those in patients with EH. ? American Federation for Medical Research 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Subjects
Estimated glomerular filtration rate; Hyperfiltration; Left ventricular hypertrophy; Left ventricular mass index; Primary aldosteronism
SDGs
Other Subjects
alpha adrenergic receptor blocking agent; angiotensin receptor antagonist; beta adrenergic receptor blocking agent; calcium channel blocking agent; dipeptidyl carboxypeptidase inhibitor; spironolactone; adult; age; analysis of covariance; Article; cardiovascular parameters; controlled study; cross-sectional study; disease association; disease severity; echocardiography; essential hypertension; estimated glomerular filtration rate; female; gender; heart left ventricle mass; human; hypertension; major clinical study; male; middle aged; observational study; primary hyperaldosteronism; propensity score; prospective study; radiological parameters; systolic blood pressure; Taiwan; aged; electrocardiography; glomerulus filtration rate; heart left ventricle hypertrophy; hyperaldosteronism; pathophysiology; physiology; procedures; Adult; Aged; Cross-Sectional Studies; Electrocardiography; Female; Glomerular Filtration Rate; Humans; Hyperaldosteronism; Hypertrophy, Left Ventricular; Male; Middle Aged; Prospective Studies; Taiwan
Publisher
BMJ Publishing Group
Type
journal article