LAUSR

Objectives: Primary aldosteronism may cause subclinical myocardial injury due to plasma aldosterone elevation. We aimed to investigate myocardial dysfunction using layer-specific strain in patients with primary aldosteronism. Methods: Our study included 62 patients with primary aldosteronism (33 with aldosterone-producing adenoma and 29 idiopathic hyperaldosteronism) and 30 patients with primary hypertension. Speckle tracking echocardiography was acquired using GE Vivid E9 equipment. Longitudinal and circumferential layer strains of the endocardium, midmyocardium and epicardium (LSendo, LSmid, LSepi, CSendo, CSmid, CSepi) were then obtained using EchoPAC BT13 workstation. Results: Patients with aldosterone-producing adenoma (369.2 pg/ml and 144), but not those with idiopathic hyperaldosteronism (220.4 pg/ml and 45), had significantly (P ⩽ 0.01) higher plasma aldosterone concentration and plasma aldosterone-to-plasma renin activity ratio (ARR) than patients with primary hypertension (183.1 pg/ml and 13). Layer-specific strain showed decreasing gradient from the endocardium to epicardium in all three groups of patients (P ⩽ 0.01). LSendo and CSendo were lowest in aldosterone-producing adenoma, intermediate in idiopathic hyperaldosteronism and highest in primary hypertension (P ⩽ 0.01 vs both groups of patients with primary aldosteronism). However, LSmid, LSepi, CSmid and CSepi were significantly (P ⩽ 0.01) lower only in the presence of aldosterone-producing adenoma than primary hypertension, but not idiopathic hyperaldosteronism ( P ≥ 0.05). Conclusion: Patients with primary aldosteronism show prominent myocardial deformation changes, to a large extent in parallel with the plasma aldosterone elevation, especially those with aldosterone-producing adenoma and at the endocardial layer.