Mild autonomous cortisol secretion in patients with aldosterone-producing adenoma and risk for cardiac remodeling and diastolic dysfunction
Authors' conclusion
The presence of MACS in patients with PA was associated with worse cardiac hypertrophy and diastolic dysfunction. Surgical adrenalectomy was able to effectively reverse cardiac remodeling in patients with PA and concurrent MACS; however, MRA therapy was not associated with significant improvements in cardiac function. These findings highlight the independent deleterious effects of cortisol on cardiovascular disease in PA.
Study context
- Population
- Patients with PA due to aldosterone-producing adenomas (APA)
- Participants
- 483 patients
- Exposure
- APA with concurrent mild autonomous cortisol secretion (MACS) vs APA without MACS
- Outcome
- Cardiac remodeling (LVMI) and diastolic function (E/e') by MACS status
- Follow-up
- Baseline
Main finding
As reported in the abstract
Prevalence of concurrent MACS in APA
21%
Observational data: associations, not effects.
Further findings
Change in left ventricular mass index (LVMI) and E/e' after adrenalectomy · one year after targeted treatment
- Significant improvements in LVMI and E/e' both with and without MACS
Change in LVMI and E/e' with mineralocorticoid receptor antagonist (MRA) treatment · one year after targeted treatment
- Significant LVMI improvement only without MACS
- MRA did not improve E/e' regardless of MACS
Original publication
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