We studied a random sample of Multi-Ethnic Study of Atherosclerosis participants who had aldosterone and PRA blood assays at 2003-2005 and underwent cardiac magnetic resonance at 2010. Participants taking angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were excluded.
The aldosterone group was composed by 615 participants, mean age 61.6 ± 8.9 years, while the renin group was 580 participants, mean age 61.5 ± 8.8 years and both groups had roughly 50% females. In multivariable analysis, 1 SD increment of log-transformed aldosterone level was associated with 0.07 g/m2 higher left ventricle (LV) mass index (P = 0.04) and 0.11 ml/m2 higher left atrium (LA) minimal volume index (P < 0.01). Additionally, higher log-transformed aldosterone was associated with lower LA maximum strain and LA emptying fraction (P < 0.01). Aldosterone levels were not significantly associated with aortic measures. Log-transformed PRA was associated with lower LV end diastolic volume index (β standardized = 0.08, P = 0.05). PRA levels were not significantly associated with LA and aortic structural or functional differences.
Higher levels of aldosterone and PRA are associated with concentric LV remodeling changes. Moreover, aldosterone was related to deleterious LA remodeling changes.
方法:我们对动脉粥样硬化参与者的多种族研究进行了随机抽样研究,这些参与者在2003-2005年进行了醛固酮和血浆肾素活性血液测定,并在2010年进行了心脏磁共振检查。排除服用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂的参与者。
结果:醛固酮组由615名参与者组成,平均年龄61.6±8.9岁,肾素组有580名参与者,平均年龄为61.5±8.8岁,两组均有约50%的女性.在多变量分析中,1对数转化醛固酮水平的SD增量与左心室质量指数高0.07g/m2(p=0.04)和左心房最小容积指数高0.11ml/m2(p<0.01)相关。此外,较高的对数转化醛固酮与左心房下最大应变和左心房排空分数相关(β标准化=-0.12,p<0.01和-0.15,p<0.01)。醛固酮水平与主动脉测量没有显着相关。经对数转化的血浆肾素活性与左心室下舒张末期容积指数相关(β标准化=0.08,p=0.05)。血浆肾素活性水平与左心房和主动脉结构或功能差异无显着相关。
结论:醛固酮水平升高和血浆肾素活性升高与同心左心室重构改变有关。此外,醛固酮与有害的左心房重构改变有关。