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Primary aldosterone

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https://www.readbyqxmd.com/read/28612447/obesity-and-the-diagnostic-accuracy-for-primary-aldosteronism
#1
Amit Tirosh, Fady Hannah-Shmouni, Charalampos Lyssikatos, Elena Belyavskaya, Mihail Zilbermint, Smita B Abraham, Maya B Lodish, Constantine A Stratakis
The effects of body mass index on the diagnostic accuracy of primary aldosteronism (PA) are inconsistent and yet important considering the high prevalence and frequent co-occurrence of obesity and hypertension. The current study included 59 adult patients who underwent a stepwise evaluation for PA, using aldosterone to renin ratio for case detection and plasma aldosterone concentration after saline suppression test and/or 24-hour urinary aldosterone after oral sodium loading for case confirmation. Body mass index had a quadratic (U-shaped) correlation with plasma aldosterone concentration, plasma renin activity, aldosterone to renin ratio, and plasma aldosterone concentration after saline suppression test...
June 13, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28594240/dimethylarginine-dimethylaminohydrolase-1-deficiency-induces-the-epithelial-to-mesenchymal-transition-in-renal-proximal-tubular-epithelial-cells-and-exacerbates-kidney-damage-in-aged-and-diabetic-mice
#2
Linlin Shi, Chenyang Zhao, Hongyun Wang, Tong Lei, Shasha Liu, Jianwei Cao, Zhongbing Lu
AIMS: Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, is mainly degraded by dimethylarginine dimethylaminohydrolase (DDAH). Emerging evidence suggests that plasma ADMA accumulation and DDAH1 activity/expression reduction are linked to chronic kidney disease (CKD) pathology, but the mechanisms remain largely unknown. Here, we examined the role of ADMA/DDAH1 in the epithelial-mesenchymal transition (EMT) of tubular epithelial cells (TECs), an important mechanism for the pathogenesis of renal fibrosis...
June 8, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28592038/-the-application-of-captopril-challenge-test-in-the-diagnosis-of-primary-aldosteronism
#3
S Chen, Z P Zeng, A L Song, L Zhu, L Lu, A L Tong, C Shi, H Z Li
Objective: To evaluate the value of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA). Methods: A total of 674 patients [(45.0±13.7) years, men 341, women 333] admitted to Peking Union Medical College Hospital from 2000 to 2015 were analyzed. Among them, 222 subjects were with essential hypertension (EH), 28 were with pheochromocytoma (PHEO), 246 were with idiopathic hyperaldosteronism (IHA) and 178 were with aldosterone producing adenoma (APA). All patients received CCT. 24 h urine sodium was measured in partial patients...
June 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28584041/primary-aldosteronism-a-common-cause-of-resistant-hypertension
#4
REVIEW
Gregory A Kline, Ally P H Prebtani, Alexander A Leung, Ernesto L Schiffrin
No abstract text is available yet for this article.
June 5, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28584016/aldosterone-producing-adenomas-histopathology-genotype-correlation-and-identification-of-a-novel-cacna1d-mutation
#5
Geok Chin Tan, Giulia Negro, Alexandra Pinggera, Nur Maya Sabrina Tizen Laim, Isa Mohamed Rose, Jiri Ceral, Ales Ryska, Long Kha Chin, Nor Azmi Kamaruddin, Norfilza Mohd Mokhtar, A Rahman A Jamal, Norlela Sukor, Miroslav Solar, Joerg Striessnig, Morris Jonathan Brown, Elena Aisha Azizan
Mutations in KCNJ5, ATP1A1, ATP2B3, CACNA1D, and CTNNB1 are thought to cause the excessive autonomous aldosterone secretion of aldosterone-producing adenomas (APAs). The histopathology of KCNJ5 mutant APAs, the most common and largest, has been thoroughly investigated and shown to have a zona fasciculata-like composition. This study aims to characterize the histopathologic spectrum of the other genotypes and document the proliferation rate of the different sized APAs. Adrenals from 39 primary aldosteronism patients were immunohistochemically stained for CYP11B2 to confirm diagnosis of an APA...
July 2017: Hypertension
https://www.readbyqxmd.com/read/28584012/nefm-neurofilament-medium-polypeptide-a-marker-for-zona-glomerulosa-cells-in-human-adrenal-inhibits-d1r-dopamine-d1-receptor-mediated-secretion-of-aldosterone
#6
Carmela Maniero, Sumedha Garg, Wanfeng Zhao, Timothy Isaac Johnson, Junhua Zhou, Mark Gurnell, Morris J Brown
Heterogeneity among aldosterone-producing adenomas (APAs) has been highlighted by the discovery of somatic mutations. KCNJ5 mutations predominate in large zona fasciculata (ZF)-like APAs; mutations in CACNA1D, ATP1A1, ATP2B3, and CTNNB1 are more likely to be found in small zona glomerulosa (ZG)-like APAs. Microarray comparison of KCNJ5 mutant versus wild-type APAs revealed significant differences in transcriptomes. NEFM, encoding a neurofilament subunit which is a D1R (dopamine D1 receptor)-interacting protein, was 4-fold upregulated in ZG-like versus ZF-like APAs and 14-fold more highly expressed in normal ZG versus ZF...
June 5, 2017: Hypertension
https://www.readbyqxmd.com/read/28584010/androstenedione-and-17-%C3%AE-hydroxyprogesterone-are-better-indicators-of-adrenal-vein-sampling-selectivity-than-cortisol
#7
Giulio Ceolotto, Giorgia Antonelli, Giuseppe Maiolino, Maurizio Cesari, Giacomo Rossitto, Valeria Bisogni, Mario Plebani, Gian Paolo Rossi
For identification of potentially surgically curable primary aldosteronism, guidelines recommend use of adrenal vein sampling (AVS) that requires selective catheterization of both adrenal veins as verified by using the cortisol-derived selectivity index. Unfortunately, bilaterally selective studies are not obtained under unstimulated conditions in a proportion of the cases ranging between 15% and 50% depending on the cutoff used. We therefore investigated whether 17-α-hydroxyprogesterone and androstenedione, which showed a higher step-up between adrenal vein and inferior vena cava blood than cortisol, can ascertain selectivity when cortisol failed to do so...
June 5, 2017: Hypertension
https://www.readbyqxmd.com/read/28580623/the-relationship-of-circulating-relaxin-2-concentrations-with-short-term-prognosis-in-patients-with-acute-heart-failure-the-relahf-study
#8
Pablo Herrero-Puente, Belén Prieto-García, María García-García, Pere Llorens, Francisco Javier Martín-Sánchez, Javier Jacob, Alexandre Mebazaa, Christian Mueller, Alan S Maisel, Víctor Gil, Pablo García-Hernandez, Òscar Miró
AIMS: This study aimed to determine the frequency of detectable relaxin-2 concentrations and associated factors in patients with acute heart failure (AHF) and to establish relationships with short-term outcome and clinical and analytical parameters. METHODS AND RESULTS: We performed a prospective, analytical, observational, multicentre study with cohort follow-up. We collected sociodemographic variables, previous history, basal status, previous treatment, vital signs, electrocardiographic and analytical data in the emergency department...
June 5, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28576688/rating-the-blood-pressure-outcome-after-adrenalectomy-for-unilateral-primary-aldosteronism
#9
Olivier Steichen
No abstract text is available yet for this article.
May 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28576687/outcomes-after-adrenalectomy-for-unilateral-primary-aldosteronism-an-international-consensus-on-outcome-measures-and-analysis-of-remission-rates-in-an-international-cohort
#10
Tracy A Williams, Jacques W M Lenders, Paolo Mulatero, Jacopo Burrello, Marietta Rottenkolber, Christian Adolf, Fumitoshi Satoh, Laurence Amar, Marcus Quinkler, Jaap Deinum, Felix Beuschlein, Kanako K Kitamoto, Uyen Pham, Ryo Morimoto, Hironobu Umakoshi, Aleksander Prejbisz, Tomaz Kocjan, Mitsuhide Naruse, Michael Stowasser, Tetsuo Nishikawa, William F Young, Celso E Gomez-Sanchez, John W Funder, Martin Reincke
BACKGROUND: Although unilateral primary aldosteronism is the most common surgically correctable cause of hypertension, no standard criteria exist to classify surgical outcomes. We aimed to create consensus criteria for clinical and biochemical outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism and apply these criteria to an international cohort to analyse the frequency of remission and identify preoperative determinants of successful outcome. METHODS: The Primary Aldosteronism Surgical Outcome (PASO) study was an international project to develop consensus criteria for outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism...
May 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28572599/comparisons-of-microvascular-and-macrovascular-changes-in-aldosteronism-related-hypertension-and-essential-hypertension
#11
Monica Varano, Pierluigi Iacono, Massimiliano M Tedeschi, Claudio Letizia, Mario Curione, Claudio Savoriti, Erika Baiocco, Laura Zinnamosca, Cristiano Marinelli, Barbara Boccassini, Mariacristina Parravano
Case-control observational study to evaluate the microvascular and macrovascular changes in patients with hypertension secondary to primary aldosteronism (PA), essential hypertension (EH) and healthy subjects. Measurements of arterial stiffness including augmentation index (AIx) and pulse wave velocity (PWV) were assessed using a TensioClinic arteriograph system. Retinal microcirculation was imaged by a Retinal Vessel Analyzer (RVA) and a non-midriatic camera (Topcon-TRC-NV2000). IMEDOS software analyzed the retinal artery diameter (RAD), retinal vein diameters (RVD) and arteriole-to-venule ratio (AVR) of the vessels coming off the optic disc...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28571891/renin-angiotensin-aldosterone-inhibition-in-the-treatment-of-cardiovascular-disease
#12
REVIEW
Carlos M Ferrario, Adam E Mullick
A collective century of discoveries establishes the importance of the renin angiotensin aldosterone system in maintaining blood pressure, fluid volume and electrolyte homeostasis via autocrine, paracrine and endocrine signaling. While research continues to yield new functions of angiotensin II and angiotensin-(1-7), the gap between basic research and clinical application of these new findings is widening. As data accumulates on the efficacy of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers as drugs of fundamental importance in the treatment of cardiovascular and renal disorders, it is becoming apparent that the achieved clinical benefits is suboptimal and surprisingly no different than what can be achieved with other therapeutic interventions...
May 29, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28566337/age-related-autonomous-aldosteronism
#13
Kazutaka Nanba, Anand Vaidya, Gordon H Williams, Isabel Zheng, Tobias Else, William E Rainey
Background -Both aging and inappropriate secretion of aldosterone increase the risk for developing cardiovascular disease; however, the influence of aging on aldosterone secretion and physiology is not well understood. Methods -The relationship between age and adrenal aldosterone synthase (CYP11B2) expression was evaluated in 127 normal adrenals from deceased kidney donors (age 9mo-68y). Following immunohistochemistry, CYP11B2 expressing area and areas of abnormal foci of CYP11B2 expressing cells, called aldosterone-producing cell clusters (APCCs), were analyzed...
May 31, 2017: Circulation
https://www.readbyqxmd.com/read/28556585/a-practical-approach-to-diagnosing-endocrine-hypertension
#14
REVIEW
Jun Yang, Jimmy Shen, Peter J Fuller
Hypertension is a leading cardiovascular risk factor that remains difficult to manage in a large segment of the population. Secondary causes of hypertension, which are amenable to targeted treatment or even cure, may contribute to poor blood pressure control. The most common endocrine cause, primary aldosteronism, requires biochemical screening as there are often no symptoms or signs other than hypertension. Screening tests should be done after adequate preparation to optimise the results and minimise the confounding effects of diet and medications...
May 27, 2017: Nephrology
https://www.readbyqxmd.com/read/28545803/impact-of-a-multidisciplinary-heart-failure-postdischarge-management-clinic-on-medication-adherence
#15
Lingyun Lu, Cynthia A Jackevicius, Noelle K de Leon, Alberta L Warner, Donald S Chang, Freny Vaghaiwalla Mody
PURPOSE: Disease management programs have been associated with improved adherence to heart failure (HF) medications. However, there remain limited data on the benefit of a comprehensive multidisciplinary HF postdischarge management (PDM) clinic that promptly follows HF-related hospitalization on evidence-based HF medication adherence. OBJECTIVE: The aim of this study was to evaluate the effects of an HF-PDM clinic on adherence to evidence-based HF medication therapy...
May 22, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28542926/effect-of-spironolactone-on-exercise-tolerance-and-arterial-function-in-older-adults-with-heart-failure-with-preserved-ejection-fraction
#16
Bharathi Upadhya, William G Hundley, Peter H Brubaker, Timothy M Morgan, Kathryn P Stewart, Dalane W Kitzman
OBJECTIVES: To evaluate the effects of an aldosterone antagonist on exercise intolerance in older adults with heart failure and preserved ejection fraction (HFpEF). DESIGN: Randomized, placebo-controlled, double-blind trial. SETTING: Academic medical center, Winston-Salem, North Carolina. PARTICIPANTS: Older adults (N = 80, aged 71 ± 1; 80% female) with stable compensated HFpEF and controlled blood pressure (BP)...
May 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28540934/monozygotic-twins-discordant-for-primary-aldosteronism-a-case-report
#17
Y Kobayashi, K Yatsu, K Nakata-Shimokihara, N Inoue, T Fujikawa, N Hirawa, S Umemura, F Satoh, G P Rossi, K Tamura
No abstract text is available yet for this article.
May 25, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28540931/hyperkalemia-in-both-surgically-and-medically-treated-patients-with-primary-aldosteronism
#18
N Wada, Y Shibayama, H Umakoshi, T Ichijo, Y Fujii, K Kamemura, T Kai, R Sakamoto, A Ogo, Y Matsuda, T Fukuoka, M Tsuiki, T Suzuki, M Naruse
Hyperkalemia is an important complication of adrenalectomy for patients with primary aldosteronism (PA). The frequency of hyperkalemia after medication using mineralocorticoid receptor antagonists (MRAs) for PA is unclear. The aim of this study is to investigate the frequency and the risk factors of hyperkalemia after surgery and medication for PA. The data of 376 patients with PA registered in a multicentre-collaborative study in Japan, including surgically treated patients (group A; n=142) and medically treated patients with MRAs (group B; n=234) were studied...
May 25, 2017: Journal of Human Hypertension
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
#19
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
#20
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
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