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This meta-analysis aimed to compare the effects of two treatment strategies, mineralocorticoid receptor antagonists (MRAs) and adrenalectomy, on the regression of LV remodeling in patients with PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Embase, PubMed, and Cochrane Library were searched for studies reporting the effect of adrenalectomy or medical therapy on reversing LV mass index (LVMI) in patients with PA. The outcome of interest was the reduction in LVMI after treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1197 patients with PA from 10 studies were included in the analysis. The meta-analysis demonstrated that both adrenalectomy and MRAs improved LVMI in patients with PA (adrenalectomy: standardized mean difference [SMD] = \u22120.49, 95% CI = \u22120.65 to \u22120.33; MRAs: SMD = \u22120.35, 95% CI = \u22120.48 to \u22120.22). The reduction in LVMI was greater following adrenalectomy in direct comparison analyses (difference-in-differences SMD = \u22120.15, 95% CI = \u22120.26 to \u22120.03). However, the effect size was small, and the impact of MRA optimization could not be assessed. In studies focusing specifically on unilateral PA, adrenalectomy demonstrated greater LVMI reduction than MRAs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta-analysis suggests that both adrenalectomy and MRAs improve LV remodeling. Although adrenalectomy was generally associated with slightly greater LVMI reductions than MRAs, the impact of optimized MRA therapy on LVMI reduction remains uncertain. When focusing specifically on patients with unilateral PA, adrenalectomy was associated with more pronounced regression of LV remodeling compared with MRA therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf271","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T12:33:40Z","timestamp":1767357220000},"page":"S1-S13","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the impact of adrenalectomy and mineralocorticoid receptor antagonists for primary aldosteronism on left ventricular remodeling: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"194","author":[{"given":"Yu-Ching","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch , Hsinchu 300 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uei-Lin","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Taoyuan Min Sheng General Hospital , Taoyuan 330 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Sheng","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei 100 ,","place":["Taiwan"]},{"name":"Primary Aldosteronism Center at National Taiwan University Hospital , Taipei 100 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-6674","authenticated-orcid":false,"given":"Zheng-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch , Yun-Lin 640 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Che-Wei","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Cancer Center , Taipei 100 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenifer M","family":"Brown","sequence":"additional","affiliation":[{"name":"Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]},{"name":"Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-9252","authenticated-orcid":false,"given":"Anand","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vin-Cent","family":"Wu","sequence":"additional","affiliation":[{"name":"Primary Aldosteronism Center at National Taiwan University Hospital , Taipei 100 ,","place":["Taiwan"]},{"name":"Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei 100 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2859-5117","authenticated-orcid":false,"given":"Cheng-Hsuan","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei 100 ,","place":["Taiwan"]},{"name":"Primary Aldosteronism Center at National Taiwan University Hospital , Taipei 100 ,","place":["Taiwan"]},{"name":"Center for Adrenal Disorders, Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8153-1441","authenticated-orcid":false,"given":"Yen-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal 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