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Endocrine Abstracts (2018) 56 P85 | DOI: 10.1530/endoabs.56.P85

1Division of Endocrinology and Centre for Applied Biomedical Research, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy; 2Institute of Cardiology, University of Bologna, Bologna, Italy.


Introduction: Cardiovascular morbidity is more prevalent in primary aldosteronism (PA) than in essential hypertension. Preclinical studies have shown a possible association between ascending aorta dilatation and PA, probably mediated by the mineralocorticoid receptor.

Patients and methods: A total of 84 patients attending the Endocrinology Unit of the S. Orsola-Malpighi University Hospital of Bologna, (Italy) were evaluated. Thirty-nine patients had a diagnosis of PA. The control group (NS) consisted of 45 hypertensive patients with an adrenal adenoma or hyperplasia, in whom primary aldosteronism, hypercortisolism and pheocromocytoma were appropriately excluded. All patients underwent transthoracic echocardiographic assessment at baseline. Ten PA patients underwent adrenalectomy due to unilateral adrenal disease, whereas the remaining 29 PA subjects were treated with a mineralocorticoid receptor antagonist. The aortic root was measured on each echocardiographic assessment. PA patients underwent a further echocardiographic evaluation during follow-up.

Results: PA and NS groups were homogeneous as to age and body surface area. The aortic root was significantly higher at baseline in PA group as compared with NS group (34.9±5.3 mm vs 32.2±3.9 mm, P<0.01). Age was significantly different between the surgically treated and medically treated PA patients (47.7±9.1 years vs 57.1±9.9 years respectively, P=0.01). In PA group, the mean duration of follow-up was 4.2±2.3 years. Within the surgically treated PA, the aortic root measured 34.9±5.3 mm before adrenalectomy and 33.9±4.9 mm at follow-up (P=0.47). In the medically treated PA group, the aortic root measured 34.6±4.7 mm at baseline and 35.1±4.8 mm at follow-up (P=0.94). Also, percentage variation did not show statistical significance in either group.

Conclusion: PA patients showed larger aortic roots as compared with a homogeneous hypertensive population. Our preliminary follow-up data suggest that treatment of primary aldosteronism might not reverse vascular damage, thus suggesting a pathogenesis of irreversible vascular fibrosis induced by aldosterone excess.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

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