Session: MON 723-757-Renin-Angiotensin-Aldosterone System/Endocrine Hypertension
Bench to Bedside
Poster Board MON-735
In carotid intima media thickness(IMT) using arotid artery ultrasound sonography and cardio ankle vascular index (CAVI), organic arteriosclerosis-related change was observed. On the other hand, the percent flow-mediated dilatation(%FMD) have been proposed as surrogate markers for the detection of premature atherosclerosis. In this presentation, we examined a change of %FMD in before and after primary aldosteronism (PA) treatment.
Twenty six cases (12 men, average age 51.2 years old) that it was diagnosed PA from November, 2011 to September, 12 were selected for this investigation. Ten patients were diagnosed with an aldosterone producing adenoma (APA) and 14 (right: 6 and left: 4 cases) was bilateral adrenal hyperplasia(BHA), and 2 were ignorance. To evaluate a macroangiopathy, aldosterone / renin ratio (ARR) and blood pressure (BP), %FMD, IMT, CAVI were measured. In addition, we compared %FMD and IMT, CAVI between before treatment and 6 months after treatment of PA.
ARR in all cases was 964±1210. ARR with APA was significantly higher than with BHA (1834±1516 vs 338±260, p<0.001 ). Systolic BP was 142.2±16.1mmHg and diastolic BP was 84.3±9.5mmHg.
Percent change in arterial diameter of %FMD in diastole was lower than in systole (4.12±3.61% vs 4.43±3.84%). MaxIMT showed mild hypertrophy (right side was 1.16±0.40 mm and left was 1.39±0.55mm, respectively), however no cases had any plaques (obviously). CAVI did not increased significantly (right side was 7.55±1.18 and left was 7.56±1.15, respectively). Although any treatments specifically changed neither IMT nor CAVI, vascular endothelial function was inclined to impair because %FMD was decreased after treatments (6.65±6.31% to 4.88±6.67 % in systole, 6.20±5.90 to 5.44±3.88 % in diastole, respectively).
The fact that any treatments for PA change neither IMT nor CAVI consistent with ability of the examinations which observe the arteriosclerotic change of the tissue. Although this study revealed that %FMD was inclined to impair after treatments for PA patients, some reports revealed that administration of angiotensin receptor blockers makes %FMD improved in hypertensive patients . We suggest that the result of our study involved by a decrease in the volume of circulating blood and/or activation of the rennin-angiotensin system.
Nothing to Disclose: NH, MS, AY, KO, MY, TH
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