Cardiac Magnetic Resonance Imaging of Myocardial Mass and Fibrosis in Primary Aldosteronism

Overview

Journal Endocr Connect

Specialty Endocrinology

Date 2018 Feb 15

PMID 29440130

Citations 6

Authors

Marianne Aa Grytaas

Kjersti Sellevag

Hrafnkell B Thordarson

Eystein S Husebye

Kristian Lovas

Terje H Larsen

Affiliations

Soon will be listed here.

Abstract

Background: Primary aldosteronism (PA) is associated with increased cardiovascular morbidity, presumably due to left ventricular (LV) hypertrophy and fibrosis. However, the degree of fibrosis has not been extensively studied. Cardiac magnetic resonance imaging (CMR) contrast enhancement and novel sensitive T1 mapping to estimate increased extracellular volume (ECV) are available to measure the extent of fibrosis.

Objectives: To assess LV mass and fibrosis before and after treatment of PA using CMR with contrast enhancement and T1 mapping.

Methods: Fifteen patients with newly diagnosed PA (PA1) and 24 age- and sex-matched healthy subjects (HS) were studied by CMR with contrast enhancement. Repeated imaging with a new scanner with T1 mapping was performed in 14 of the PA1 and 20 of the HS median 18 months after specific PA treatment and in additional 16 newly diagnosed PA patients (PA2).

Results: PA1 had higher baseline LV mass index than HS (69 (53-91) vs 51 (40-72) g/m; < 0.001), which decreased significantly after treatment (58 (40-86) g/m; < 0.001 vs baseline), more with adrenalectomy ( = 8; -9 g/m; = 0.003) than with medical treatment ( = 6; -5 g/m; = 0.075). No baseline difference was found in contrast enhancement between PA1 and HS. T1 mapping showed no increase in ECV as a myocardial fibrosis marker in PA. Moreover, ECV was lower in the untreated PA2 than HS 10 min post-contrast, and in both PA groups compared with HS 20 min post-contrast.

Conclusion: Specific treatment rapidly reduced LV mass in PA. Increased myocardial fibrosis was not found and may not represent a common clinical problem.

Citing Articles

Left ventricle remodeling by CMR in treated patients with primary aldosteronism and primary systemic arterial hypertension.

Reiser C, Assuncao Jr A, Araujo-Filho J, Dantas Jr R, Bortolotto L, Parga-Filho J PLoS One. 2024; 19(12):e0316140.

PMID: 39715283 PMC: 11666001. DOI: 10.1371/journal.pone.0316140.

Strain Imaging for the Early Detection of Cardiac Remodeling and Dysfunction in Primary Aldosteronism.

Chen Y, Xu T, Xu J, Zhu L, Wang D, Li Y Diagnostics (Basel). 2022; 12(2).

PMID: 35204632 PMC: 8871189. DOI: 10.3390/diagnostics12020543.

Left Ventricular Remodeling in Patients with Primary Aldosteronism: A Prospective Cardiac Magnetic Resonance Imaging Study.

Wu T, Ren Y, Wang W, Cheng W, Zhou F, He S Korean J Radiol. 2021; 22(10):1619-1627.

PMID: 34269528 PMC: 8484156. DOI: 10.3348/kjr.2020.1291.

CMR-Verified Myocardial Fibrosis Is Associated With Subclinical Diastolic Dysfunction in Primary Aldosteronism Patients.

Zhou F, Wu T, Wang W, Cheng W, Wan S, Tian H Front Endocrinol (Lausanne). 2021; 12:672557.

PMID: 34054733 PMC: 8160454. DOI: 10.3389/fendo.2021.672557.

Aldosterone-induced cardiac damage in primary aldosteronism depends on its subtypes.

Higuchi S, Ota H, Tezuka Y, Seiji K, Takagi H, Lee J Endocr Connect. 2020; 10(1):29-36.

PMID: 33268573 PMC: 7923132. DOI: 10.1530/EC-20-0504.

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