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Endocrine

, Volume 63, Issue 3, pp 470–475 | Cite as

Larger ascending aorta in primary aldosteronism: a 3-year prospective evaluation of adrenalectomy vs. medical treatment

  • Guido Zavatta
  • Guido Di Dalmazi
  • Carmine Pizzi
  • Giovanni Bracchetti
  • Cristina Mosconi
  • Caterina Balacchi
  • Uberto Pagotto
  • Valentina VicennatiEmail author
Endocrine Surgery
  • 63 Downloads

Abstract

Objective

Primary aldosteronism is associated with higher cardiovascular morbidity as compared with essential hypertension. Vascular complications encompass myocardial infarction and cerebrovascular events. Aortic damage in primary aldosteronism has never been explored, although a few cases of ascending aorta aneurisms have been reported.

Design and methods

We consecutively enrolled patients affected by primary aldosteronism (n = 45) and compared them with patients affected by essential hypertension (n = 47), on an outpatient setting. Echocardiographic data of patients with primary aldosteronism were collected during a mean follow-up of 3 years, in subjects who underwent adrenal surgery (n = 12) and those on mineralocorticoid receptor antagonists (n = 33).

Results and conclusion

We found that patients with primary aldosteronism had larger ascending aorta diameters than those with essential hypertension before starting any specific treatment. Patients with primary aldosteronism did not show significant changes in the size of ascending aorta during a mean of 3 years of follow-up, irrespective of the type of treatment (medical vs. surgical treatment). A longer follow-up will better clarify if worsening of the aortic damage may be better prevented by surgery rather than by mineralocorticoid receptor antagonists.

Keywords

Primary aldosteronism Ascending aorta Aortic root Aortic aneurysm Aldosterone Adrenal cortex 

Abbreviations

PA

primary aldosteronism

C

hypertensive control patients with nonsecreting adrenal adenoma

BSA

body-surface-area (m2)

TTE

transthoracic echocardiogram

CT

computed tomography

CCT

captopril-challenge test

ARR

aldosterone-to-renin-ratio

MR

mineralocorticoid receptor

BP

blood pressure

TA

tubular ascending

EH

essential hypertension

LVH

left ventricular hypertrophy

Notes

Acknowledgments

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Author contributions

The authors equally contributed in writing the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Guido Zavatta
    • 1
  • Guido Di Dalmazi
    • 1
  • Carmine Pizzi
    • 2
  • Giovanni Bracchetti
    • 2
  • Cristina Mosconi
    • 3
  • Caterina Balacchi
    • 3
  • Uberto Pagotto
    • 1
  • Valentina Vicennati
    • 1
    Email author
  1. 1.Endocrinology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi HospitalAlma Mater Studiorium-University of BolognaBolognaItaly
  2. 2.Institute of Cardiology, S. Orsola-Malpighi HospitalBolognaItaly
  3. 3.Division of Radiology, S. Orsola-Malpighi HospitalBolognaItaly

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