Endocrinol Metab.  2016 Dec;31(4):567-576. 10.3803/EnM.2016.31.4.567.

Cardiac Dysfunction in Association with Increased Inflammatory Markers in Primary Aldosteronism

• Lim JS
• Park S
• Park SI
• Oh YT
• Choi E
• Kim JY
• Rhee Y

• KMID: 2373077
• DOI: http://doi.org/10.3803/EnM.2016.31.4.567

Abstract

BACKGROUND
Oxidative stress in primary aldosteronism (PA) is thought to worsen aldosterone-induced damage by activating proinflammatory processes. Therefore, we investigated whether inflammatory markers associated with oxidative stress is increased with negative impacts on heart function as evaluated by echocardiography in patients with PA.
METHODS
Thirty-two subjects (mean age, 50.3±11.0 years; 14 males, 18 females) whose aldosterone-renin ratio was more than 30 among patients who visited Severance Hospital since 2010 were enrolled. Interleukin-1β (IL-1β), IL-6, IL-8, monocyte chemoattractant protein 1, tumor necrosis factor α (TNF-α), and matrix metalloproteinase 2 (MMP-2), and MMP-9 were measured. All patients underwent adrenal venous sampling with complete access to both adrenal veins.
RESULTS
Only MMP-2 level was significantly higher in the aldosterone-producing adenoma (APA) group than in the bilateral adrenal hyperplasia (BAH). Patients with APA had significantly higher left ventricular (LV) mass and A velocity, compared to those with BAH. IL-1β was positively correlated with left atrial volume index. Both TNF-α and MMP-2 also had positive linear correlation with A velocity. Furthermore, MMP-9 showed a positive correlation with LV mass, whereas it was negatively correlated with LV end-systolic diameter.
CONCLUSION
These results suggest the possibility that some of inflammatory markers related to oxidative stress may be involved in developing diastolic dysfunction accompanied by LV hypertrophy in PA. Further investigations are needed to clarify the role of oxidative stress in the course of cardiac remodeling.

Keyword

Cytokines; Hyperaldosteronism; Heart diseases

MeSH Terms

Adenoma
Chemokine CCL2
Cytokines
Echocardiography
Heart
Heart Diseases
Humans
Hyperaldosteronism*
Hyperplasia
Hypertrophy
Interleukin-6
Interleukin-8
Male
Matrix Metalloproteinase 2
Oxidative Stress
Tumor Necrosis Factor-alpha
Veins
Chemokine CCL2
Cytokines
Interleukin-6
Interleukin-8
Matrix Metalloproteinase 2
Tumor Necrosis Factor-alpha

Figure

• 

  Fig. 1 Linear correlation between matrix metalloproteinase 2 (MMP-2) and aldosterone levels. In the current study, there was a significant linear relationship between MMP-2 and plasma aldosterone levels in patients with primary aldosteronism (R=0.448, P=0.010). The Spearman correlation was used to evaluate the linear relationship between MMP-2 and aldosterone levels. APA, aldosterone-producing adenoma; BAH, bilateral adrenal hyperplasia.

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