Endocrinology and Metabolism

  • 제33권4호
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  • Pages.485-492
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  • 2018
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  • 2093-596X(pISSN)
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  • 2093-5978(eISSN)
대한내분비학회 (The Korean Endocrine Society)
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Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism

  • Lim, Jung Soo (Department of Internal Medicine, Institute of Evidence Based Medicine, Yonsei University Wonju College of Medicine) ;
  • Hong, Namki (Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine) ;
  • Park, Sungha (Division of Cardiology, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine) ;
  • Park, Sung Il (Department of Radiology, Inje University Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Oh, Young Taik (Department of Radiology, Yonsei University College of Medicine) ;
  • Yu, Min Heui (Department of Biostatistics, Yonsei University Wonju College of Medicine) ;
  • Lim, Pil Yong (Hwacheon Public Health and Medical Care Center) ;
  • Rhee, Yumie (Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine)
  • 투고 : 2018.08.23
  • 심사 : 2018.11.05
  • 발행 : 2018.12.31
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Therefore, we investigated the impact of altered calcium homeostasis caused by excessive aldosterone on cardiovascular parameters in patients with PA. Methods: Forty-two patients (mean age $48.8{\pm}10.9$ years; 1:1, male:female) whose plasma aldosterone concentration/plasma renin activity ratio was more than 30 were selected among those who had visited Severance Hospital from 2010 to 2014. All patients underwent adrenal venous sampling with complete access to both adrenal veins. Results: The prevalence of unilateral adrenal adenoma (54.8%) was similar to that of bilateral adrenal hyperplasia. Mean serum corrected calcium level was $8.9{\pm}0.3mg/dL$ (range, 8.3 to 9.9). The corrected calcium level had a negative linear correlation with left ventricular end-diastolic diameter (LVEDD, ${\rho}=-0.424$, P=0.031). Moreover, multivariable regression analysis showed that the corrected calcium level was marginally associated with the LVEDD and corrected QT (QTc) interval (${\beta}=-0.366$, P=0.068 and ${\beta}=-0.252$, P=0.070, respectively). Conclusion: Aldosterone-mediated hypercalciuria and subsequent hypocalcemia may be partly involved in the development of cardiac remodeling as well as a prolonged QTc interval, in subjects with PA, thereby triggering deleterious effects on target organs additively.

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참고문헌

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