Re: Salt and heart size in PA

[Guest guest]

Dr Grim, have you ever had any cases where cardiomegaly was

decreased?

I know you said LVH can be corrected in months with mcb and low na.

Phyllis

On 11/14/2011 12:00 PM, Phyllis wrote:

I had a MRI of the heart. It showed LVH, cardiomyapathy

and that I should rule out for sarcodiosis.

I wonder if the MRI was seeing fibrosis. He wanted to do a

biopsy of my heart. I refused- biopsies of the heart dont

have good outcomes.

I had a CT of the lung and it didnt show adenapathy or

nodules in the lung.

Phyllis

On 11/14/2011 11:04 AM, Clarence Grim wrote:

4.

J Clin

Endocrinol Metab. 2011 Sep;96(9):2813-20.

Epub 2011 Jun 1.

Cardiac

dimensions are largely determined by dietary

salt in patients with primary aldosteronism:

results of a case-control study.

Pimenta E, Gordon RD, Ahmed AH, Cowley D, Leano R, Marwick

TH, Stowasser

M.

Source

Endocrine Hypertension Research Centre,

University of Queensland School of Medicine,

Princess andra Hospital, Brisbane,

Queensland 4102, Australia. e.pimenta@...

Abstract

CONTEXT:

Animal studies have demonstrated that

dietary sodium intake is a major influence in

the pathogenesis of aldosterone-induced

effects in the heart such as left ventricular

(LV) hypertrophy and fibrosis. LV hypertrophy

is an important predictor for cardiovascular

morbidity and mortality.

OBJECTIVE:

We aimed to investigate the relationships

between aldosterone and dietary salt and LV

dimensions in patients withprimary

aldosteronism (PA).

DESIGN AND PARTICIPANTS:

This case-control study included 21

patients with confirmed PA and 21 control

patients with essential hypertension matched

for age, gender, duration of hypertension, and

24-h systolic and diastolic blood pressure.

MAIN OUTCOME MEASURES:

Patients were evaluated by echocardiography

and 24-h urinary sodium (UNa) excretion while

consuming their usual diets.

RESULTS:

Patients with PA had significantly greater

mean LV end-diastolic diameter,

interventricular septum and posterior wall

thicknesses, LV mass (LVM) and LV mass index,

and end systolic and diastolic volumes than

control patients. UNa significantly positively

correlated with interventricular septum,

posterior wall thicknesses, and LVM in the

patients with PA but not in control patients.

In a multivariate analysis, UNa was an

independent predictor for LV wall thickness

and LV mass among the patients with PA but not

in patients with essential hypertension.

CONCLUSIONS:

These findings emphasize the importance of

dietary sodium in determining the degree of

cardiac damage in those patients with PA, and

we suggest that aldosterone excess may play a

permissive role. In patients with PA, because

a high-salt diet is associated with

greater LVM, dietary salt restriction might

reduce cardiovascular risk.

[Guest guest]

Yes it always decreases with proper RX if due to HTN.Will start to decrease in a few days, in animals in minutes.CE Grim MDOn Apr 30, 2012, at 9:29 PM, Phyllis wrote: Dr Grim, have you ever had any cases where cardiomegaly was decreased? I know you said LVH can be corrected in months with mcb and low na. Phyllis On 11/14/2011 12:00 PM, Phyllis wrote: I had a MRI of the heart. It showed LVH, cardiomyapathy and that I should rule out for sarcodiosis. I wonder if the MRI was seeing fibrosis. He wanted to do a biopsy of my heart. I refused- biopsies of the heart dont have good outcomes. I had a CT of the lung and it didnt show adenapathy or nodules in the lung. Phyllis On 11/14/2011 11:04 AM, Clarence Grim wrote: 4. J Clin Endocrinol Metab. 2011 Sep;96(9):2813-20. Epub 2011 Jun 1. Cardiac dimensions are largely determined by dietary salt in patients with primary aldosteronism: results of a case-control study. Pimenta E, Gordon RD, Ahmed AH, Cowley D, Leano R, Marwick TH, Stowasser M. Source Endocrine Hypertension Research Centre, University of Queensland School of Medicine, Princess andra Hospital, Brisbane, Queensland 4102, Australia. e.pimenta@... Abstract CONTEXT: Animal studies have demonstrated that dietary sodium intake is a major influence in the pathogenesis of aldosterone-induced effects in the heart such as left ventricular (LV) hypertrophy and fibrosis. LV hypertrophy is an important predictor for cardiovascular morbidity and mortality. OBJECTIVE: We aimed to investigate the relationships between aldosterone and dietary salt and LV dimensions in patients withprimary aldosteronism (PA). DESIGN AND PARTICIPANTS: This case-control study included 21 patients with confirmed PA and 21 control patients with essential hypertension matched for age, gender, duration of hypertension, and 24-h systolic and diastolic blood pressure. MAIN OUTCOME MEASURES: Patients were evaluated by echocardiography and 24-h urinary sodium (UNa) excretion while consuming their usual diets. RESULTS: Patients with PA had significantly greater mean LV end-diastolic diameter, interventricular septum and posterior wall thicknesses, LV mass (LVM) and LV mass index, and end systolic and diastolic volumes than control patients. UNa significantly positively correlated with interventricular septum, posterior wall thicknesses, and LVM in the patients with PA but not in control patients. In a multivariate analysis, UNa was an independent predictor for LV wall thickness and LV mass among the patients with PA but not in patients with essential hypertension. CONCLUSIONS: These findings emphasize the importance of dietary sodium in determining the degree of cardiac damage in those patients with PA, and we suggest that aldosterone excess may play a permissive role. In patients with PA, because a high-salt diet is associated with greater LVM, dietary salt restriction might reduce cardiovascular risk.