Zusammenhang von Serum-Aldosteron und der linksventrikulären Struktur und Geometrie bei Patienten mit erhaltener linksventrikulärer Ejektionsfraktion

Zusammenhang von Serum-Aldosteron und der linksventrikulären Struktur und Geometrie bei Patienten mit erhaltener linksventrikulärer Ejektionsfraktion

Serum aldosterone and its relationship to left ventricular structure and geometry in patients with preserved left ventricular ejection fraction

Manuela Knoke

Doctoral thesis

Date of Examination: 2016-03-22

Date of issue: 2016-03-04

Advisor: Edelmann, Frank PD Dr.

Referee: Meyer, Thomas Prof. Dr.

Referee: Schön, Margarete Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-0028-86ED-8

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Abstract

English

Cardiac remodelling especially left ventricular (LV) hypertrophy might be an important mechanism for aldosterone-mediated cardiovascular morbidity and mortality. In our study, we aimed to evaluate the relationship of serum aldosterone concentration with echocardiographic parameters of LV remodelling in patients with cardiovascular risk factors and preserved LV ejection fraction (LVEF>50%). Therefore, we studied 1575 participants with either risk factors for diastolic dysfunction or heart failure with preserved LVEF. All patients underwent a physical examination, laboratory and echocardiographic analyses. Our multivariate adjusted analysis showed a significant increase in LV mass, LV mass index, relative wall thickness and posterior wall thickness with increasing serum aldosterone concentration. Furthermore, higher serum aldosterone concentration was independently related to concentric LV hypertrophy by comparing the third tertile with the first tertile. Overall no associations were found between aldosterone-to-renin ratio and echocardiographic parameters. Our findings in a large cardiovascular risk cohort with preserved LVEF indicate that aldosterone plays an important role in the development of LV hypertrophy, especially in concentric LV hypertrophy.

Keywords: aldosterone; left ventricular structure; concentric left ventricular hypertrophy