Horm Metab Res 2020; 52(06): 357-365
DOI: 10.1055/a-1141-5989
Review

Atrial Fibrillation in Primary Aldosteronism

Chien-Ting Pan
1   Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
2   Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
,
Cheng-Hsuan Tsai
2   Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
3   Department of Internal Medicine, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan
,
Zheng-Wei Chen
1   Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
2   Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
,
Yi-Yao Chang
4   Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan
,
Vin-Cent Wu
5   Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
,
Chi-Sheng Hung
2   Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
6   Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
,
Yen-Hung Lin
2   Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
6   Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan
,
the TAIPAI Study Group› Institutsangaben

Funding: This research was supported by grants from the Ministry of Science and Technology (MOST 106–2314-B-002–048 –MY3 and MOST 106–2314-B-002–169-MY3) and National Taiwan University Hospital (NTUH 107-A141).
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Abstract

Primary aldosteronism (PA) is the most common cause of secondary hypertension. Increasing evidence has demonstrated an increased cardiovascular risk in patients with PA compared to those with essential hypertension (EH), including atrial fibrillation (AF), the most prevalent arrhythmia among adults that is associated with an elevated risk of subsequent cerebro-cardiovascular adverse events. The mechanisms of increased prevalence of AF in PA patients are complex. Excessive aldosterone production is regarded to be a key component in the pathogenesis of AF, in addition to arterial hypertension and electrolyte imbalance. In addition, several translational and clinical studies have reported that structural remodeling with atrial fibrosis and electrical remodeling with arrhythmogenicity induced by an excess of aldosterone also play major roles in AF genesis. Clinical studies from several registries and meta-analysis have reported an increased prevalence and risk of AF in PA patients compared to EH patients. Recent trials have further demonstrated a reduction in the risk of new-onset atrial fibrillation (NOAF) after adrenalectomy, while the results of medical treatment with mineralocorticoid receptor antagonists (MRAs) have been inconsistent. This review outlines the current evidence of the relationship between PA and AF, and highlights recent progress in the management of PA with regards to the development of AF.



Publikationsverlauf

Eingereicht: 16. Dezember 2019

Angenommen: 09. März 2020

Artikel online veröffentlicht:
14. April 2020

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