The Captopril Challenge Test Predicts Cardiac Structure and Dysfunction in Primary Aldosteronism
Authors' conclusion
Higher post-CCT PAC was significantly associated with worse left ventricular remodeling and diastolic dysfunction but also greater improvements in cardiac structure and dysfunction following targeted treatment. These findings highlight the prognostic and therapeutic values of the CCT that the post-CCT PAC predicts the severity of cardiac disease and also the potential for therapeutic benefits in PA.
Study context
- Population
- Primary aldosteronism (PA) patients with complete captopril challenge test (CCT) and echocardiographic data
- Participants
- 540 patients
- Exposure
- Post-captopril challenge test (CCT) plasma aldosterone concentration (PAC) and cardiac structure and function
- Outcome
- Association of post-CCT PAC with baseline cardiac structure and diastolic function
- Follow-up
- Baseline
Main finding
As reported in the abstract
baseline
- Post-CCT PAC showed a significant linear association with left ventricular mass index (LVMI) and E/e' (restricted cubic spline analyses)
- Post-CCT PAC significantly associated with baseline LVMI, E/e' and left atrial volume index (LAVI), regardless of multiple model adjustments (linear regression)
Observational data: associations, not effects.
Further findings
Improvement in LVMI, E/e' and LAVI after PA-targeted treatment · 1 year
- Patients with higher post-CCT PAC experienced the greatest improvements in LVMI, E/e' and LAVI
Baseline aldosterone levels and cardiac parameters
- Baseline aldosterone associated only with baseline LVMI and its improvement after treatment, not with baseline or improvement of E/e' or LAVI
Original publication
The Captopril Challenge Test Predicts Cardiac Structure and Dysfunction in Primary Aldosteronism. J Clin Endocrinol Metab. Published 2 January 2025. doi:10.
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