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Horm Metab Res 2016; 48(04): 238-241
DOI: 10.1055/s-0035-1559769
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Epicardial Fat Thickness and Primary Aldosteronism

G. Iacobellis
1   Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, USA
,
L. Petramala
2   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University “La Sapienza”, Rome, Italy
,
C. Marinelli
2   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University “La Sapienza”, Rome, Italy
,
C. Calvieri
2   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University “La Sapienza”, Rome, Italy
,
L. Zinnamosca
2   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University “La Sapienza”, Rome, Italy
,
A. Concistrè
2   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University “La Sapienza”, Rome, Italy
,
G. Iannucci
2   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University “La Sapienza”, Rome, Italy
,
G. De Toma
3   Department of Surgery “Pietro Valdoni”, University “La Sapienza”, Rome, Italy
,
C. Letizia
2   Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical Specialities, University “La Sapienza”, Rome, Italy
› Author Affiliations
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Publication History

received 04 April 2015

accepted 04 August 2015

Publication Date:
16 March 2016 (online)

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Abstract

Primary aldosteronism (PA) is associated with increased cardiovascular risk and left ventricle (LV) changes. Given its peculiar biomolecular and anatomic properties, excessive epicardial fat, the heart-specific visceral fat depot, can affect LV morphology. Whether epicardial fat can be associated with aldosterone and LV mass (LVM) in patients with PA is unknown. We performed ultrasound measurement of the epicardial fat thickness (EAT) in 79 consecutive newly diagnosed patients with PA, 59 affected by bilateral adrenal hyperplasia (IHA), 20 aldosterone-producing adenoma (APA), and 30 patients with essential hypertension (low renin hypertension) (EH). The 3 groups did not differ by age, sex distribution, body mass index (BMI), waist circumference (WC), or blood pressure values. EAT showed a trend of increase in both APA and IHA groups when compared to patients with EH (8.3±1.8 vs. 7.9±1.3 vs. 7.8±2 mm, respectively). EAT was significantly correlated with indexed LVM in the IHA group (r=0.35, p<005), better than BMI or WC were. Interestingly, EAT was highly associated with plasma aldosterone concentrations (PAC) and PAC/plasma renin activity (PRA) (PAC/PRA) in the APA group (p=0.58, p=0.37, p<0.01, for both), whereas BMI and WC were not. EAT was also correlated with PRA in the IHA group (p=−0.28, p<0.05). Our study indicates a novel and interesting interaction of EAT with PA, independent of obesity, abdominal fat and blood pressure control. EAT can locally affect LVM, at least in patients with IHA. Further studies in larger population will be required to confirm these findings.

Key words

epicardial fat - primary aldosteronism - obesity
 

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