Primary aldosteronism is often associated with heart failure (HF), and is reportedly difficult to treat in some cases. We report a case of severe HF associated with primary aldosteronism. A patient with HF, who was suspected of having primary aldosteronism, was referred to and examined at our hospital. After detailed examination, the patient was diagnosed with exacerbation of HF, and was treated at our department. Catheterization after admission revealed Forrester class IV HF. The patient was treated with catecholamine infusion in combination with medical treatment including mineralocorticoid receptor antagonists. The patient was diagnosed with hypertension due to primary aldosteronism and intractable secondary HF with increased peripheral vascular resistance. An open adrenalectomy was successfully performed under intra-aortic balloon pumping. Right heart catheterization, performed soon thereafter, demonstrated improvement in the patient's blood pressure and hemodynamics. We speculate that the improved cardiac function resulted from a reduction in the vascular resistance, as a consequence of the adrenalectomy. < Acute decompensated heart failure (HF) is one of the cardiovascular complications in patients with primary aldosteronism. However, there are few reports on the effective management of severe HF with concomitant primary aldosteronism. Although the appropriate time-frame for performing adrenalectomy remains undetermined, the procedure may effectively improve hemodynamics of patients with primary aldosteronism; this facilitates treatment of severe HF.>.
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http://dx.doi.org/10.1016/j.jccase.2021.08.001 | DOI Listing |
Front Endocrinol (Lausanne)
December 2024
Department of Hypertension, People's Hospital of Henan University, Henan Provincial People's Hospital, Zhengzhou, China.
Introduction: The clinical biochemical characteristics and target organ damage (TOD) in patients with plasma aldosterone concentrations (PAC) ranging from 50 to 100 ng/L after a saline infusion test (SIT) have not been fully studied.
Methods: A total of 611 hypertensive patients with an elevated aldosterone-to-renin ratio (ARR) who underwent a supine SIT at Henan Provincial People's Hospital were enrolled. The patients were divided into three groups according to their post-SIT PAC: <50 ng/L (control group), 50-100 ng/L (indeterminate post-SIT results group), and >100 ng/L (PA group).
Hypertens Res
December 2024
Department of Internal Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan.
The synergistic interplay between cortisol and aldosterone is critical for maintaining homeostasis, particularly in blood pressure regulation, fluid balance, and stress response. Cortisol, a glucocorticoid, and aldosterone, a mineralocorticoid, often act in tandem to regulate sodium retention and blood volume. Dysregulation of these hormones, as seen in hyperaldosteronism or Cushing's syndrome, contributes to hypertension and metabolic imbalances.
View Article and Find Full Text PDFJ Clin Endocrinol Metab
December 2024
Division of Endocrinology, Diabetes and Hypertension, Harvard Medical School, Brigham and Women's Hospital, 221 Longwood Avenue, RFB-2, Boston, MA, 02115, USA.
Context: Women versus men have more Salt sensitive blood pressure (SSBP) and higher stimulated aldosterone (ALDO) levels, suggesting that their increased SSBP is secondary to a relative hyper-ALDO state. Contrariwise, men versus women have higher sedentary ALDO levels.
Objective: Thus, the present project was designed to address the question are women versus men in a relatively hyper-ALDO state?
Methods: 363 women, and 483 men were selected from HyperPATH cohort to assess the potential underlying mechanism for observed sex differences.
BMC Endocr Disord
December 2024
National Hospital of Sri Lanka, Colombo, Sri Lanka.
Background: Reninoma is a rare cause of secondary hypertension, which can be cured with surgery if identified early before any target organ damage occurs. It leads to hypokalaemia and hypertension and typically responds well to treatment with renin-angiotensin-aldosterone system blockers. However, confirmation of the diagnosis and the localisation of this rare culprit lesion can be challenging.
View Article and Find Full Text PDFHypertens Res
December 2024
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
KCNJ5 somatic mutations in aldosterone-producing adenoma (APA) are linked to higher left ventricular mass index (LVMI) and worse diastolic function. We previously identified an association between plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) and an aldosterone-induced increase in LVMI and diastolic dysfunction. This study aimed to investigate the association between the presence of KCNJ5 somatic mutation and plasma TIMP-1 in APA patients.
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