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Increased plasma aldosterone-to-renin ratio is associated with impaired left ventricular longitudinal functional reserve in patients with uncomplicated hypertension

Authors
 Eui-Young Choi  ;  Jong-Won Ha  ;  Se-Jung Yoon  ;  Chi-Young Shim  ;  Hye-Sun Seo  ;  Sungha Park  ;  Young-Guk Ko  ;  Seok-Min Kang  ;  Donghoon Choi  ;  Se-Joong Rim  ;  Yangsoo Jang  ;  Namsik Chung 
Citation
 JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol.21(3) : 251-256, 2008 
Journal Title
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
ISSN
 0894-7317 
Issue Date
2008
MeSH
Aldosterone/blood* ; Exercise Test ; Female ; Fractional FlowReserve, Myocardial* ; Humans ; Hypertension/blood* ; Hypertension/complications ; Hypertension/diagnostic imaging* ; Male ; Middle Aged ; Renin/blood* ; Ultrasonography ; VentricularDysfunction,Left/blood* ; VentricularDysfunction,Left/complications ; VentricularDysfunction,Left/diagnostic imaging*
Keywords
Aldosterone/blood* ; Exercise Test ; Female ; Fractional FlowReserve, Myocardial* ; Humans ; Hypertension/blood* ; Hypertension/complications ; Hypertension/diagnostic imaging* ; Male ; Middle Aged ; Renin/blood* ; Ultrasonography ; VentricularDysfunction,Left/blood* ; VentricularDysfunction,Left/complications ; VentricularDysfunction,Left/diagnostic imaging*
Abstract
Relative aldosterone excess is associated with endothelial dysfunction and higher incidence of end organ damage. We sought to investigate whether plasma aldosterone-to-renin ratio (ARR) is associated with left ventricular (LV) longitudinal function reserve to exercise in patients with controlled hypertension. In the patients with controlled and uncomplicated hypertension without overt LV hypertrophy, plasma aldosterone concentrations (ng/dL) and renin activities (ng/mL/h) were measured. Then 28 consecutive patients with higher ARR (group II, ARR > or = 30, 55 +/- 10 years) and 56 age- and sex-matched patients with lower ARR (group I, ARR < 30) underwent supine bicycle exercise echocardiography. Despite similar 24-hour blood pressure, LV mass index was significantly higher in group II (91.1 +/- 16.4 vs 101.7 +/- 18.2 g/m(2), P = .008). Early diastolic and systolic mitral annular velocity (E' and S', cm/s) at 50-W exercise was significantly lower in group II compared with group I (9.91 +/- 1.66 vs 8.67 +/- 1.65 cm/s, P = .002; 9.52 +/- 1.71 vs 8.46 +/- 1.79, P = .010, respectively) despite similar resting values. Longitudinal diastolic functional reserve at 25-W and 50-W exercise, defined as DeltaE' (change from resting E', cm/s) of group II was significantly lower than that of group I (2.60 +/- 1.42 vs 1.85 +/- 1.44 cm/s, P = .016; 3.40 +/- 1.48 vs 2.36 +/- 1.43 cm/s, P = .003, respectively). In conclusion, in patients with hypertension without overt LV hypertrophy, increased ARR is associated with increased LV mass, and impaired LV longitudinal functional reserve during exercise.
Full Text
http://www.sciencedirect.com/science/article/pii/S0894731707006116
DOI
10.1016/j.echo.2007.08.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Seo, Hye Sun(서혜선)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Yoon, Se Jung(윤세정)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106615
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