Clinical Research Papers:
The relationship among cardiac structure, dietary salt and aldosterone in patients with primary aldosteronism
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Chi-Sheng Hung1, Xue-Ming Wu2, Ching-Way Chen3, Ying-Hsien Chen1, Vin-Cent Wu1, Che-Wei Liao4, Yi-Yao Chang5, Ruh-Fang Yen6, Ching-Chu Lu6, Mao-Yuan M. Su7, Kao-Lang Liu7, Chin-Chen Chang7, Li-Yu Daisy Liu8, Kwan-Dun Wu1, Yen-Hung Lin1 and the TAIPAI Study Group
1Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
2Department of Internal Medicine, Taoyuan General Hospital, Taoyuan, Taiwan
3Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
4Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
5Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
6Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
7Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
8Department of Agronomy, Biometry Division, National Taiwan University, Taipei, Taiwan
Yen-Hung Lin, email: [email protected]
Keywords: primary aldosteronism, salt intake, left ventricular mass, TAIPAI
Received: December 08, 2016 Accepted: April 05, 2017 Published: April 28, 2017
Salt intake is highly associated with cardiac structure in patients with primary aldosteronism (PA). We investigated the association among dietary salt intake, aldosterone and left ventricular mass in patients with PA. We enrolled 158 patients with PA and 158 patients with essential hypertension. We measured 24-hour urinary sodium (UNa) and aldosterone (UAldo) level and echocardiography parameters. In patients with PA, the UAldo level was positively correlated with left ventricular mass index (LVMI; r=0.231, p=0.007). The UNa level was not linearly correlated with left ventricular structural parameters in patients with PA. To test if UNa has a non-linear relationship with LVMI among patients with PA, we categorized the participants according to the tertile of UNa (low, median, and high tertile). PA patients with medium tertile of UNa had significant lower LVMI than the other two groups (LVMI: 144.1 ± 42.9, 121.1 ± 33.4, and 136.7 ± 32.8 g/m2, from the lowest to the highest tertile of Una; analysis of variance p=0.006, post-hoc p <0.05). Multifactor analysis of variance confirmed this finding after adjustment for clinical parameters. Post-hoc analyses revealed that the high UNa tertile was associated with higher left ventricular end-diastolic volume compared with medium UNa tertile; while the low UNa tertile was associated with higher mean wall thickness compared with medium UNa tertile. The findings imply the reasons for increased LVMI may be different in patients with the highest and lowest UNa tertile. In conclusion, the medium tertile of 24-hour UNa is associated with lowest LVMI in patients with PA.
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