Reversal of cardiac damage after treatment for aldosterone-producing adenoma and idiopathic hyperaldosteronism - A Prospective Cardiac Magnetic Resonance Imaging study

Chenxiao Xu; Jiayu Sun; Tao Wu; Tao Chen; Lu Tang; Wei Wang; Fangli Zhou; Deying Wen; Yan Ren

doi:10.1530/endoabs.99.P1

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Endocrine Abstracts (2023) 99 P1 | DOI: 10.1530/endoabs.99.P1

ECE2024 Poster Presentations Adrenal and Cardiovascular Endocrinology (95 abstracts)

Reversal of cardiac damage after treatment for aldosterone-producing adenoma and idiopathic hyperaldosteronism – A Prospective Cardiac Magnetic Resonance Imaging study

Chenxiao Xu ¹ , Jiayu Sun ² , Tao Wu ² , Tao Chen ¹ , Lu Tang ² , Wei Wang ¹ , Fangli Zhou ¹ , Deying Wen ² & Yan Ren ¹

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¹Department of Endocrinology and Metabolism, Adrenal Center, West China Hospital, Sichuan University, Chengdu, China; ²Department of Radiology, West China Hospital, Sichuan University, Chengdu, China

Objective: At present, there are no studies in which authors report the use of cardiac magnetic resonance imaging (CMR) to evaluate the differences in myocardial strain between patients with aldosterone-producing adenomas (APAs) and those with idiopathic hyperaldosteronism (IHA) or the improvement in myocardial strain after treatment.

Methods: In this study, 71 patients with APA and 51 patients with IHA were prospectively enrolled from the Department of Endocrinology and Metabolism, West China Hospital, and all patients underwent CMR examination at the time of diagnosis. Differences in cardiac chamber volume, mass index and myocardial strain, including global radial strain (GRS), global circumferential strain (GCS) and global longitudinal strain (GLS), were compared between the two groups. Among them, 41 patients were re-examined via CMR one year after treatment, and the changes in cardiac parameters were also analyzed.

Results: Sex, duration of hypertension, blood pressure, fasting blood glucose, and lipid levels were comparable between the APA patients and the IHA patients at the time of diagnosis, and the IHA patients were older. There were no significant differences in the LVEF; native T1 time; or global radial, circumferential, or longitudinal peak strain (all P>0.05), but the APA patients had higher LV massi, LVEDVi, LVESVi, and RVEDVi (all P<0.05). Correlation analysis revealed that the log PAC and log ARR were positively correlated with the LV massi, LVEDVi, and LVESVi (R=0.19–0.27, P=0.003–0.042) and negatively correlated with the serum potassium concentration (R=−0.24–0.28, P=0.002–0.008). At the 1-year post-treatment follow-up assessment, patients showed significant decreases in the LVEDVi, LVESVi and LV massi and an increase in the global circumferential peak strain (all P<0.05).

Conclusion: Patients with APAs have more significant chamber enlargement and ventricular hypertrophy than patients without APAs, but the extents of myocardial strain and fibrosis may not be significantly different from those in patients with IHA. Improvements in the left ventricular structure and myocardial function 1 year after treatment are also noteworthy.

Key words: aldosterone-producing adenoma, idiopathic hyperaldosteronism, cardiac magnetic resonance, cardiac damage