Reversible Heart Rhythm Complexity Impairment in Patients with Primary Aldosteronism

Overview

Journal Sci Rep

Specialty Science

Date 2015 Aug 19

PMID 26282603

Citations 16

Authors

Yen-Hung Lin

Vin-Cent Wu

Men-Tzung Lo

Xue-Ming Wu

Chi-Sheng Hung

Kwan-Dun Wu

Chen Lin

Yi-Lwun Ho

Michael Stowasser

Chung-Kang Peng

Affiliations

Soon will be listed here.

Abstract

Excess aldosterone secretion in patients with primary aldosteronism (PA) impairs their cardiovascular system. Heart rhythm complexity analysis, derived from heart rate variability (HRV), is a powerful tool to quantify the complex regulatory dynamics of human physiology. We prospectively analyzed 20 patients with aldosterone producing adenoma (APA) that underwent adrenalectomy and 25 patients with essential hypertension (EH). The heart rate data were analyzed by conventional HRV and heart rhythm complexity analysis including detrended fluctuation analysis (DFA) and multiscale entropy (MSE). We found APA patients had significantly decreased DFAα2 on DFA analysis and decreased area 1-5, area 6-15, and area 6-20 on MSE analysis (all p < 0.05). Area 1-5, area 6-15, area 6-20 in the MSE study correlated significantly with log-transformed renin activity and log-transformed aldosterone-renin ratio (all p < = 0.01). The conventional HRV parameters were comparable between PA and EH patients. After adrenalectomy, all the altered DFA and MSE parameters improved significantly (all p < 0.05). The conventional HRV parameters did not change. Our result suggested that heart rhythm complexity is impaired in APA patients and this is at least partially reversed by adrenalectomy.

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References

Costa M, Goldberger A, Peng C . Multiscale entropy analysis of complex physiologic time series. Phys Rev Lett. 2002; 89(6):068102. DOI: 10.1103/PhysRevLett.89.068102. View

Strauch B, Petrak O, Zelinka T, Wichterle D, Holaj R, Kasalicky M . Adrenalectomy improves arterial stiffness in primary aldosteronism. Am J Hypertens. 2008; 21(10):1086-92. DOI: 10.1038/ajh.2008.243. View

Kuo C, Wu V, Huang K, Wang S, Chang C, Lu C . Verification and evaluation of aldosteronism demographics in the Taiwan Primary Aldosteronism Investigation Group (TAIPAI Group). J Renin Angiotensin Aldosterone Syst. 2011; 12(3):348-57. DOI: 10.1177/1470320310391329. View

Lee H, Hung C, Wu X, Wu V, Liu K, Wang S . Myocardial ultrasound tissue characterization of patients with primary aldosteronism. Ultrasound Med Biol. 2012; 39(1):54-61. DOI: 10.1016/j.ultrasmedbio.2012.08.023. View

Lin Y, Lin L, Chen A, Wu X, Lee J, Su T . Adrenalectomy improves increased carotid intima-media thickness and arterial stiffness in patients with aldosterone producing adenoma. Atherosclerosis. 2011; 221(1):154-9. DOI: 10.1016/j.atherosclerosis.2011.12.003. View

Peng C, Costa M, Goldberger A . ADAPTIVE DATA ANALYSIS OF COMPLEX FLUCTUATIONS IN PHYSIOLOGIC TIME SERIES. Adv Adapt Data Anal. 2009; 1(1):61-70. PMC: 2798133. DOI: 10.1142/S1793536909000035. View

Hung C, Ho Y, Chang Y, Wu V, Wu X, Lee J . Twenty-four-hour urinary aldosterone predicts inappropriate left ventricular mass index in patients with primary aldosteronism. ScientificWorldJournal. 2014; 2013:294594. PMC: 3891226. DOI: 10.1155/2013/294594. View

Richman J, Moorman J . Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol. 2000; 278(6):H2039-49. DOI: 10.1152/ajpheart.2000.278.6.H2039. View

Rossi G . Prevalence and diagnosis of primary aldosteronism. Curr Hypertens Rep. 2010; 12(5):342-8. DOI: 10.1007/s11906-010-0134-2. View

10.

Rossi G, Di Bello V, Ganzaroli C, Sacchetto A, Cesari M, Bertini A . Excess aldosterone is associated with alterations of myocardial texture in primary aldosteronism. Hypertension. 2002; 40(1):23-7. DOI: 10.1161/01.hyp.0000023182.68420.eb. View

11.

Lo M, Novak V, Peng C, Liu Y, Hu K . Nonlinear phase interaction between nonstationary signals: a comparison study of methods based on Hilbert-Huang and Fourier transforms. Phys Rev E Stat Nonlin Soft Matter Phys. 2009; 79(6 Pt 1):061924. PMC: 2730740. DOI: 10.1103/PhysRevE.79.061924. View

12.

Munakata M, Aihara A, Imai Y, Omata K, Abe K, Yoshinaga K . Increased gain in baroreceptor-heart rate reflex in patients with primary aldosteronism. J Hypertens. 1995; 13(12 Pt 2):1648-53. View

13.

Costa M, Goldberger A, Peng C . Multiscale entropy analysis of biological signals. Phys Rev E Stat Nonlin Soft Matter Phys. 2005; 71(2 Pt 1):021906. DOI: 10.1103/PhysRevE.71.021906. View

14.

Yen R, Wu V, Liu K, Cheng M, Wu Y, Chueh S . 131I-6beta-iodomethyl-19-norcholesterol SPECT/CT for primary aldosteronism patients with inconclusive adrenal venous sampling and CT results. J Nucl Med. 2009; 50(10):1631-7. DOI: 10.2967/jnumed.109.064873. View

15.

Milliez P, Girerd X, Plouin P, Blacher J, Safar M, Mourad J . Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J Am Coll Cardiol. 2005; 45(8):1243-8. DOI: 10.1016/j.jacc.2005.01.015. View

16.

Tsuji H, Larson M, Venditti Jr F, Manders E, Evans J, Feldman C . Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation. 1996; 94(11):2850-5. DOI: 10.1161/01.cir.94.11.2850. View

17.

Maser R, Lenhard M, Kolm P, Edwards D . Direct renin inhibition improves parasympathetic function in diabetes. Diabetes Obes Metab. 2012; 15(1):28-34. PMC: 3524360. DOI: 10.1111/j.1463-1326.2012.01669.x. View

18.

Riordan Jr W, Norris P, Jenkins J, Morris Jr J . Early loss of heart rate complexity predicts mortality regardless of mechanism, anatomic location, or severity of injury in 2178 trauma patients. J Surg Res. 2009; 156(2):283-9. DOI: 10.1016/j.jss.2009.03.086. View

19.

Lin Y, Huang H, Chang Y, Lin C, Lo M, Liu L . Multi-scale symbolic entropy analysis provides prognostic prediction in patients receiving extracorporeal life support. Crit Care. 2014; 18(5):548. PMC: 4221713. DOI: 10.1186/s13054-014-0548-3. View

20.

Yuan H, Lin C, Tsai P, Chang F, Lin K, Hu H . Acute increase of complexity in the neurocardiovascular dynamics following carotid stenting. Acta Neurol Scand. 2010; 123(3):187-92. DOI: 10.1111/j.1600-0404.2010.01384.x. View