gms | German Medical Science

28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

24. bis 27.11.2004, Hannover

Aldosterone levels during head-up tilt correlate with myocardial structure and function

Aldosteron-Spiegel während des Kipptischversuchs korrelieren mit myokardialer Struktur und Funktion

Meeting Abstract (Hypertonie 2004)

  • B. Schmidt - Universität Erlangen-Nürnberg (Nürnberg, D)
  • T. Agafonov - Universität Erlangen-Nürnberg (Nürnberg, D)
  • A. Rastätter - Universität Erlangen-Nürnberg (Nürnberg, D)
  • M. Schleich - Universität Erlangen-Nürnberg (Nürnberg, D)
  • T. Schäufele - Universität Erlangen-Nürnberg (Nürnberg, D)
  • T. Schwarz - Universität Erlangen-Nürnberg (Nürnberg, D)
  • R. Schmieder - Universität Erlangen-Nürnberg (Nürnberg, D)

Hypertonie 2004. 28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Hannover, 24.-27.11.2004. Düsseldorf, Köln: German Medical Science; 2005. Doc04hochP99

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2004/04hoch099.shtml

Veröffentlicht: 10. August 2005

© 2005 Schmidt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Aldosterone (aldo) is linked to myocardial damage in heart failure. The importance of aldo for myocardial changes in hypertension is less clear. We have shown that in healthy and mildly hypertensives male volunteers a diminished ability to suppress aldo levels after salt loading is correlated with diastolic and systolic left ventricular (LV) dysfunction. In the present study we examined aldo levels during head-up-tilt in correlation to myocardial changes.

We enrolled 40 young male volunteers. 20 of them were mildly hypertensive. We measured LV and right ventricular (RV) mass, LV relative wall thickness (RWT), LV diastolic (ratio of peak late to early velocities, VmaxA/E ) and systolic (midwall fractional fiber shortening, midFFS) function and RV function (RV ejection fraction, RV-EF) by echocardiography, Doppler echocardiography and cardiac MRT. Head-up-tilt was performed for 30 minutes. Aldo levels were measured before (after 60 minutes of rest), during and within 120 minutes after tilting. The Aldo-AUC (area under the aldo concentration-time-curve) and the ratio of the maximal aldo level/baseline (Aldo max/base ratio) were used as measures of aldo reagibility.

The volunteers were young (age 27,9 5,4) and rather lean (BMI 25 4 kg/m2). They were normotensive or mildly hypertensive (BP 135/82 14/11 mmHg). Aldo-AUC was positively correlated with VmaxA/E (r=0.34, p=0.03), RWT (r=0.34, p=0.03) and negatively with RV-EF (r=-0,43, p=0.008). For Aldo max/base ratio similar results were obtained (Vmax A/E r=0.34, p= 0.03; RWT r=0.29, p=0.07; RV-EF r=-0.51, p=0.001). In addition an inverse correlation with midFFS could be found (r=-0.33, p=0.04).

These data suggest that there is a link between an increased reagibility of the RAAS and myocardial dysfunction and concentric LV-remodelling. Furthermore, we were able to show a correlation of aldo reagibility and systolic dysfunction of the RV suggesting that aldo induces changes that are independent of systemic blood pressure.