ECEESPE2025 Poster Presentations Adrenal and Cardiovascular Endocrinology (169 abstracts)
Treatment of primary aldosteronism improves cardiac autonomic function
Denise Bruedgam 1 , Daniel Heinrich 1,2 , Christine Meyer-Zürn 3 , Isabel Stüfchen 1 , Paul Schwarzlmueller 1 , Hediyeh Daneshpour 1 , Erik Petersenn 1 , Petra Zimmermann 4 , Sinan Deniz 5 , Martin Bidlingmaier 1 , Tracy Ann Williams 1 , Konstantinos Rizas 1 , Felix Mahfoud 3 , Martin Reincke 1 & Johannes Schier 3
1LMU Klinikum, Medizinische Klinik und Poliklinik IV, Munich, Germany; 2Hormon-und Stoffwechselzentrum München, Munich, Germany; 3Universitätsspital Basel, Klinik für Kardiologie, Basel, Switzerland; 4LMU Klinikum, Klinik für Allgemein-, Viszeral-und Transplantationschirurgie, Munich, Germany; 5LMU Klinikum, Klinik für Radiologie, Munich, Germany
JOINT3441
Introduction: Primary aldosteronism (PA) is among the most common causes for secondary hypertension. Cardiovascular mortality is influenced independently by aldosterone excess and sympathetic activation. Periodic repolarization dynamics (PRD) is an electrocardiographic marker of repolarization instability associated with sympathetic activity. It has shown promising results in predicting mortality and arrhythmias in patients with cardiovascular disease. Therefore, we analyzed PRD values of PA patients before and after specific PA treatment.
Methods: We included 85 patients, recruited from 2020 to 2022, who were part of the German Conn’s Registry and retrospectively investigated PRD values using a high resolution ECG at baseline and at 6–12 months follow-up.
Results: Baseline PRD values could be significantly lowered after specific treatment at follow-up (2.39 deg2 vs. 1.66 deg2; P=0.02). MRA treated patients were the driver of this PRD reduction (n=54, 1.31 (0.81; 2.64)), as PRD reduction was not significant in the adrenalectomy group (n=31, 1.93(1.05; 5.13)). Baseline PRD correlated significantly with baseline aldosterone. Spironolactone dosage could not significantly be correlated to PRD reduction. In the MRA treatment subgroup, renin stimulation after treatment was not an independent factor in PRD reduction. Surprisingly, cortisol co-secretion was also not significantly correlated to PRD values at baseline.
Conclusion: PRD as marker of sympathetic activation could be shown to be reduced in PA patients after specific treatment, indicating a lower burden of sympathetic activation. The reduction was mostly due to patients treated with MRA. Further studies are necessary in order to determine whether PRD can be a long term prediction tool for cardiovascular mortality in patients with PA.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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