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primary aldosteronism

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https://www.readbyqxmd.com/read/28529209/quantitative-value-of-aldosterone-renin-ratio-for-detection-of-aldosterone-producing-adenoma-the-aldosterone-renin-ratio-for-primary-aldosteronism-aquarr-study
#1
Giuseppe Maiolino, Giacomo Rossitto, Valeria Bisogni, Maurizio Cesari, Teresa Maria Seccia, Mario Plebani, Gian Paolo Rossi
BACKGROUND: Current guidelines recommend use of the aldosterone-renin ratio (ARR) for the case detection of primary aldosteronism followed by confirmatory tests to exclude false-positive results from further diagnostic workup. We investigated the hypothesis that this could be unnecessary in patients with a high ARR value if the quantitative information carried by the ARR is taken into due consideration. METHODS AND RESULTS: We interrogated 2 large data sets of prospectively collected patients studied with the same predefined protocol, which included the captopril challenge test...
May 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28526806/the-relationship-among-cardiac-structure-dietary-salt-and-aldosterone-in-patients-with-primary-aldosteronism
#2
Chi-Sheng Hung, Xue-Ming Wu, Ching-Way Chen, Ying-Hsien Chen, Vin-Cent Wu, Che-Wei Liao, Yi-Yao Chang, Ruh-Fang Yen, Ching-Chu Lu, Mao-Yuan M Su, Kao-Lang Liu, Chin-Chen Chang, Li-Yu Daisy Liu, Kwan-Dun Wu, Yen-Hung Lin
Salt intake is highly associated with cardiac structure in patients with primary aldosteronism (PA). We investigated the association among dietary salt intake, aldosterone and left ventricular mass in patients with PA. We enrolled 158 patients with PA and 158 patients with essential hypertension. We measured 24-hour urinary sodium (UNa) and aldosterone (UAldo) level and echocardiography parameters. In patients with PA, the UAldo level was positively correlated with left ventricular mass index (LVMI; r=0.231, p=0...
April 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28520883/effect-of-isotonic-versus-hypotonic-maintenance-fluid-therapy-on-urine-output-fluid-balance-and-electrolyte-homeostasis-a-crossover-study-in-fasting-adult-volunteers
#3
N Van Regenmortel, T De Weerdt, A H Van Craenenbroeck, E Roelant, W Verbrugghe, K Dams, M L N G Malbrain, T Van den Wyngaert, P G Jorens
Background.: Daily and globally, millions of adult hospitalized patients are exposed to maintenance i.v. fluid solutions supported by limited scientific evidence. In particular, it remains unclear whether fluid tonicity contributes to the recently established detrimental effects of fluid, sodium, and chloride overload. Methods.: This crossover study consisted of two 48 h study periods, during which 12 fasting healthy adults were treated with a frequently prescribed solution (NaCl 0...
May 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28515448/involvement-of-vascular-aldosterone-synthase-in-phosphate-induced-osteogenic-transformation-of-vascular-smooth-muscle-cells
#4
Ioana Alesutan, Jakob Voelkl, Martina Feger, Denise V Kratschmar, Tatsiana Castor, Sobuj Mia, Michael Sacherer, Robert Viereck, Oliver Borst, Christina Leibrock, Meinrad Gawaz, Makoto Kuro-O, Stefan Pilz, Andreas Tomaschitz, Alex Odermatt, Burkert Pieske, Carsten A Wagner, Florian Lang
Vascular calcification resulting from hyperphosphatemia is a major determinant of mortality in chronic kidney disease (CKD). Vascular calcification is driven by aldosterone-sensitive osteogenic transformation of vascular smooth muscle cells (VSMCs). We show that even in absence of exogenous aldosterone, silencing and pharmacological inhibition (spironolactone, eplerenone) of the mineralocorticoid receptor (MR) ameliorated phosphate-induced osteo-/chondrogenic transformation of primary human aortic smooth muscle cells (HAoSMCs)...
May 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28512920/an-audit-of-adherence-to-heart-failure-guidelines-in-an-australian-hospital-a-pharmacist-perspective
#5
Viviane Khalil, Melanie Danninger, Wei Wang, Hanan Khalil
RATIONALE, AIMS, AND OBJECTIVES: The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evidence-based therapy (EBT) for CHF on discharge at this Australian metropolitan hospital and factors affecting its prescribing. The secondary aims are to examine the proportion of patients prescribed EBT on discharge on cardiac wards compared to medical wards and to explore the role of the pharmacist in the management of these patients...
May 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28493291/prevalence-of-primary-aldosteronism-among-patients-with-type-2-diabetes
#6
M Tancredi, G Johansson, B Eliasson, R Eggertsen, U Lindblad, S Dahlqvist, H Imberg, M Lind
CONTEXT: Diabetes and hypertension coexist in 40-60% of individuals with type 2 diabetes. The coexistence of this two conditions is associated with increased risk of retinopathy, nephropathy and cardiovascular disease. OBJECTIVE: To investigate the prevalence of primary aldosteronism (PA) in a general cohort of persons with type 2 diabetes. DESIGN: Cross-sectional study involving 6 diabetes outpatient clinics in Sweden. PATIENTS: Were enrolled individuals with type 2 diabetes between February 2008 and December 2013...
May 10, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28492512/aldosterone-and-mineralocorticoid-receptors-physiology-and-pathophysiology
#7
John W Funder
Aldosterone is a uniquely terrestrial hormone, first appearing in lungfish, which have both gills and lungs. Mineralocorticoid receptors (MRs), on the other hand, evolved much earlier, and are found in cartilaginous and bony fish, presumptive ligand cortisol. MRs have equivalent high affinity for aldosterone, progesterone, and cortisol; in epithelia, despite much higher cortisol circulating levels, aldosterone selectively activates MRs by co-expression of the enzyme 11β-hydroxysteroid dehydrogenase, Type 11...
May 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28491445/primary-adrenal-lymphoma-causing-hypoaldosteronism-in-a-cat
#8
Jessica F Romine, Angela R Kozicki, Marc S Elie
CASE SUMMARY: A 10-year-old, 5.1 kg (11.2 lb), male castrated cat was presented with signs of lethargy and decreased appetite at home after being previously healthy. Serum biochemical analysis identified normokalemia (5.1 mmol/l; reference interval [RI] 3.4-5.6 mmol/l) and severe hyponatremia (123 mmol/l; RI 145-158 mmol/l), with an Na/K ratio of 24 (RI 32-41). Baseline serum cortisol was low to normal, but serum aldosterone was markedly decreased with a pre-adrenocorticotropic hormone stimulation concentration of 13 pmol/l (RI 194-388 pmol/l) and post-adrenocorticotropic hormone stimulation concentration of 21 pmol/l (RI 277-721 pmol/l)...
July 2016: JFMS Open Rep
https://www.readbyqxmd.com/read/28476142/dipeptidyl-peptidase-4-dpp-4-inhibition-with-linagliptin-reduces-western-diet-induced-myocardial-traf3ip2-expression-inflammation-and-fibrosis-in-female-mice
#9
Annayya R Aroor, Javad Habibi, Hemanth Kumar Kandikattu, Mona Garro-Kacher, Brady Barron, Dongqing Chen, Melvin R Hayden, Adam Whaley-Connell, Shawn B Bender, Thomas Klein, Jaume Padilla, James R Sowers, Bysani Chandrasekar, Vincent G DeMarco
BACKGROUND: Diastolic dysfunction (DD), a hallmark of obesity and primary defect in heart failure with preserved ejection fraction, is a predictor of future cardiovascular events. We previously reported that linagliptin, a dipeptidyl peptidase-4 inhibitor, improved DD in Zucker Obese rats, a genetic model of obesity and hypertension. Here we investigated the cardioprotective effects of linagliptin on development of DD in western diet (WD)-fed mice, a clinically relevant model of overnutrition and activation of the renin-angiotensin-aldosterone system...
May 5, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28472315/physiological-phenotyping-for-personalized-therapy-of-uncontrolled-hypertension-in-africa
#10
Adeseye Akintunde, Justus Nondi, Kennedy Gogo, Erika S W Jones, Brian L Rayner, Daniel G Hackam, J David Spence
OBJECTIVES: African and African American hypertensives tend to retain salt and water, with lower levels of plasma renin and more resistant hypertension. We tested the hypothesis that physiological phenotyping with plasma renin and aldosterone would improve blood pressure control in uncontrolled hypertensives in Africa. METHODS: Patients at hypertension clinics in Nigeria, Kenya, and South Africa with a systolic blood pressure >140 mm Hg or diastolic pressure > 90 mm Hg despite treatment were allocated to usual care (UC) vs...
May 2, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28472301/new-gain-of-function-mutation-shows-cacna1d-as-recurrently-mutated-gene-in-autism-spectrum-disorders-and-epilepsy
#11
Alexandra Pinggera, Luisa Mackenroth, Andreas Rump, Jens Schallner, Filippo Beleggia, Bernd Wollnik, Jörg Striessnig
CACNA1D encodes the pore-forming α1-subunit of Cav1.3, an L-type voltage-gated Ca2+-channel. Despite the recent discovery of two de novo missense gain-of-function mutations in Cav1.3 in two individuals with autism spectrum disorder (ASD) and intellectual disability CACNA1D has not been considered a prominent ASD-risk gene in large scale genetic analyses, since such studies primarly focus on likely-disruptive genetic variants. Here we report the discovery and characterization of a third de novo missense mutation in CACNA1D (V401L) in a patient with ASD and epilepsy...
May 4, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28469946/a-normotensive-patient-with-primary-aldosteronism
#12
Xiao Lin, Xiaoyu Miao, Pengli Zhu, Fan Lin
This study was to report a case of normotensive patient with primary aldosteronism who was admitted to our department recently. The patient was a 33-year-old male with right adrenal incidentaloma, but without any symptom. He has no history of hypertension, and blood pressure was normal when measured at multiple time points during hospitalization stay. The 24-hour ambulatory blood pressure prompted a normal blood pressure with the existence of circadian rhythm. The patient was diagnosed with primary aldosteronism by screening and confirmatory test...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28468286/clinical-utility-of-the-adrenocorticotropin-stimulation-test-with-without-dexamethasone-suppression-for-definitive-and-subtype-diagnosis-of-primary-aldosteronism
#13
Kosuke Inoue, Masao Omura, Chiho Sugisawa, Yuya Tsurutani, Jun Saito, Tetsuo Nishikawa
The adrenocorticotropin (ACTH) stimulation test (AST) has been reported to be useful for diagnosing primary aldosteronism (PA), particularly for differentiating PA subtypes under 1-mg dexamethasone suppression (DS). The aim of our study was to clarify the effect of 1-mg DS on AST results. A retrospective cohort study was conducted using data for 48 patients (PA: 30/48). We estimated the difference in plasma aldosterone concentration (PAC) responsiveness to ACTH stimulation with single (AST alone) and combined (AST under 1-mg DS) tests within the same patient...
April 30, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28462715/clinical-value-of-measuring-the-renin-aldosterone-levels-optimising-the-management-of-uncontrolled-resistant-hypertension
#14
Michalis Doumas, Chrysoula Boutari, Costas Tsioufis, Kyriakos Dimitriadis, Areti Triantafyllou, Stella Douma
Resistant hypertension (HT) is a common clinical entity with debilitating cardiovascular consequences. The highly heterogeneous nature of resistant HT requires a meticulous work-up to exclude 'pseudo-resistance' and secondary forms of arterial HT. Resistant HT has recently gained wide scientific interest due to the introduction of interventional methods (renal sympathetic denervation and carotid baroreceptor stimulation) for blood pressure (BP) reduction in this patient population. Despite however the recent advances in understanding the pathophysiology and the clinical characteristics of the disease, the appropriate management of resistant HT remains elusive...
April 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28461157/cholesterol-delivery-to-the-adrenal-glands-estimated-by-adrenal-venous-sampling-an-in%C3%A2-vivo-model-to-determine-the-contribution-of-circulating-lipoproteins-to-steroidogenesis-in-humans
#15
Edward Buitenwerf, Robin P F Dullaart, Anneke C Muller Kobold, Thera P Links, Wim J Sluiter, Margery A Connelly, Michiel N Kerstens
BACKGROUND: Cholesterol, required for adrenal steroid hormone synthesis, is at least in part derived from circulating lipoproteins. The contribution of high-density lipoproteins (HDL) and low-density lipoproteins (LDL) to adrenal steroidogenesis in humans is unclear. OBJECTIVE: The aim of the study was to determine the extent to which HDL and LDL are taken up by the adrenal glands using samples obtained during adrenal venous sampling (AVS). METHODS: AVS was successfully performed in 23 patients with primary aldosteronism...
April 5, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28458768/early-diagnosis-in-familial-glucocorticoid-deficiency
#16
Fatima Al Jneibi, Tawfiq Hen, Jaishen Rajah, Rajendran Nair
Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive condition, characterized by marked atrophy of zona fasiculata and reticalaris with preservation of zona glomerulosa. Out of more than 50 published cases, 18 patients died as a result of glucocorticoid insufficiency. The main objective of this report is to emphasize the early diagnosis and treatment in our 17 month-old patient. Her presenting features following an upper respiratory tract infection were hypoglycemia, seizures as well as deep hyperpigmentation of the limbs and lips...
2017: Dermato-endocrinology
https://www.readbyqxmd.com/read/28458337/outcomes-analysis-of-surgical-and-medical-treatments-for-patients-with-primary-aldosteronism
#17
Kyeong Seon Park, Jung Hee Kim, Ye Seul Yang, A Ram Hong, Dong-Hwa Lee, Min Kyong Moon, Sung Hee Choi, Chan Soo Shin, Sang Wan Kim, Seong Yeon Kim
Patients with aldosterone-producing adenomas are treated using surgery, and patients with idiopathic hyperaldosteronism receive medical treatment using mineralocorticoid receptor antagonists (MRAs). However, the outcomes of surgical and medical treatment for primary aldosteronism (PA) remain unclear. Therefore, we compared the outcomes of surgical and medical treatment for PA and aimed to identify a specific subgroup that might benefit from medical treatment. We identified 269 patients who were treated for PA (unilateral excess: 221 cases; bilateral excess: 48 cases) during 2000-2015 at the Seoul National University Hospital and two other tertiary centers...
April 29, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28454836/right-ventricular-dysfunction-in-tetralogy-of-fallot-inhibition-of-the-renin-angiotensin-aldosterone-system-redefine-trial-rationale-and-design-of-a-randomized-double-blind-placebo-controlled-clinical-trial
#18
Jouke P Bokma, Michiel M Winter, Esmée M Kornaat, Hubert W Vliegen, Arie P van Dijk, Joost P van Melle, Folkert J Meijboom, Martijn C Post, Jacqueline K Berbee, Aeilko H Zwinderman, Barbara J M Mulder, Berto J Bouma
Renin-angiotensin-aldosterone system (RAAS) inhibition with angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors is beneficial in patients with acquired left ventricular dysfunction. Adult patients with tetralogy of Fallot (TOF) with right ventricular (RV) dysfunction are at high risk for heart failure, arrhythmias, and sudden cardiac death. However, the efficacy of RAAS inhibition has not been established in these patients. METHODS: The REDEFINE is an investigator-initiated, multicenter, prospective, randomized, double-blind, placebo-controlled trial to study the effects of the angiotensin II receptor blocker losartan (target dosage of 150 mg once daily) in adult patients with TOF...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28449833/rational-medical-therapy-is-the-key-to-effective-cardiovascular-disease-prevention
#19
REVIEW
J David Spence
In an era in which medicine personalized on the basis of genotyping is being proposed, it is timely to recognize that existing therapies could be markedly improved if they were on the basis of more effective application of principles on the basis of available phenotyping. Blood pressure control, which is poor on a worldwide basis, is a major opportunity to reduce cardiovascular risk. There are many genetic variants that have a small effect on blood pressure, but specific therapies are not available for most of them...
May 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28449402/postprandial-renal-haemodynamic-effect-of-lixisenatide-versus-once-daily-insulin-glulisine-in-type-2-diabetes-patients-on-insulin-glargine-an-8-week-randomised-open-label-trial
#20
Lennart Tonneijck, Marcel H A Muskiet, Mark M Smits, Trynke Hoekstra, Mark H H Kramer, A H Jan Danser, Michaela Diamant, Jaap A Joles, Daniël H van Raalte
AIMS: To determine whether lixisenatide, a prandial short-acting glucagon-like peptide receptor agonist (GLP-1RA), ameliorates postprandial glomerular hyperfiltration in type 2 diabetes mellitus (T2DM)-patients compared to insulin-glulisine (iGlu) . METHODS: Postprandial renal haemodynamic effects of 8-week treatment with lixisenatide 20 µg versus once-daily titrated iGlu were measured in 35 overweight T2DM-patients inadequately controlled on insulin-glargine, with or without metformin (mean±SD age 62 ± 7years, HbA1c 8...
April 27, 2017: Diabetes, Obesity & Metabolism
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