オオツキ　ミチオ   Ootsuki Michio   大月　道夫    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Nadir Aldosterone Levels After Confirmatory Tests Are Correlated With Left Ventricular Hypertrophy in Primary Aldosteronism
掲載誌名	正式名：Hypertension 略　 称：Hypertension ISSNコード：0194911X/15244563
掲載区分	国外
巻・号・頁	75(6),pp.1475-1482
著者・共著者	Ohno, Y. Sone, M. Inagaki, N. Kawashima, A. Takeda, Y. Yoneda, T. Kurihara, I. Itoh, H. Tsuiki, M. Ichijo, T. Katabami, T. Wada, N. Sakamoto, R. Ogawa, Y. Yoshimoto, T. Yamada, T. Kawashima, J. Matsuda, Y. Kobayashi, H. Kamemura, K. Yamamoto, K. Otsuki, M. Okamura, S. Izawa, S. Okamoto, R. Tamura, K. Tanabe, A. Naruse, M. Jpas Jras Study Group
発行年月	2020
概要	Left ventricular hypertrophy (LVH) is often seen in patients with primary aldosteronism (PA), and the prevalence of LVH is reportedly higher among patients with PA than patients with essential hypertension. However, the correlation between aldosterone levels and LVH is undefined, and how aldosterone affects LVH in patients with PA remains unclear. We, therefore, retrospectively assessed a large PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) to reveal the factors associated with LVH in patients with PA without suspected autonomous cortisol secretion. In the 1186 patients with PA studied, the basal plasma aldosterone concentration, plasma renin activity, and the aldosterone-to-renin ratio did not significantly correlate with left ventricular LV mass index (LVMI) in single or multiple regression analyses. However, the plasma aldosterone concentration after the captopril challenge test or saline-infusion test, which are associated with autonomous aldosterone secretion, correlated significantly with LVMI, even after adjusting for patients'backgrounds, including age and blood pressure. In addition, hypokalemia and the unilateral subtype also correlated with LVMI. Longitudinal subanalysis of medically or surgically treated patients with PA showed significant reductions in LVMI in both the surgery (63.0+/-18.1 to 55.3+/-19.5 g/m(2.7), P<0.001) and drug treatment (56.8+/-14.1 to 52.1+/-13.5 g/m(2.7), P<0.001) groups. Our results suggest the autonomous aldosterone secretion level, not the basal aldosterone level itself, is relevant to LVH in patients with PA. In addition, the elevated LVMI seen in patients with PA is at least partially reversible with surgical or medical treatment.
DOI	10.1161/HYPERTENSIONAHA.119.14601
文献番号	32248705