{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:28:21Z","timestamp":1782286101560,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Patients with primary aldosteronism (PA) have cardiac remodeling due to hemodynamic and non-hemodynamic causes. However, component analysis of cardiac remodeling and reversal in PA patients is lacking. We investigated components of cardiac remodeling and reversal after adrenalectomy in patients with aldosterone-producing adenoma (APA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study prospectively enrolled 304 APA patients who received adrenalectomy and 271 with essential hypertension (EH). Clinical, biochemical and echocardiographic data were collected in both groups and 1 year after surgery in the APA patients. The hemodynamic and non-hemodynamic components of left ventricular (LV) remodeling were represented by predicted left ventricular mass index (LVMI) (pLVMI) and inappropriately excessive LVMI (ieLVMI, defined as LVMI-pLVMI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After propensity score matching, 213 APA and 213 EH patients were selected. APA patients had higher hemodynamic (pLVMI) and non-hemodynamic (ieLVMI) components of LV remodeling than EH patients. In multivariate analysis, baseline pLVMI was correlated with systolic blood pressure (SBP) and serum potassium, whereas ieLVMI was correlated with log plasma aldosterone concentration but not blood pressure. Post-operative echocardiography was available in 207 patents and showed significant decreases in both pLVMI and ieLVMI after adrenalectomy. In multivariate analysis, \u0394pLVMI was correlated with SBP, \u0394SBP, and pre-operative pLVMI, whereas \u0394ieLVMI was correlated with \u0394log aldosterone-to-renin ratio (ARR) and pre-operative ieLVMI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study concluded that extensive cardiac remodeling in APA patients occurs through hemodynamic and non-hemodynamic causes. Adrenalectomy can improve both hemodynamic and non-hemodynamic components of LV remodeling. Regressions of pLVMI and ieLVMI were correlated with decreases in blood pressure and ARR, respectively.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.646097","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T17:26:53Z","timestamp":1618853213000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Hemodynamic and Non-Hemodynamic Components of Cardiac Remodeling in Primary Aldosteronism"],"prefix":"10.3389","volume":"12","author":[{"given":"Chien-Ting","family":"Pan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Ming","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Hsuan","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Yao","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng-Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Chen","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Ching","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Che-Wei","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Li","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lung-Chun","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ru","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Sheng","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Hung","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-4061","article-title":"The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/j.jfma.2017.06.004","article-title":"Case detection and diagnosis of primary aldosteronism - The consensus of Taiwan Society of Aldosteronism","volume":"116","author":"Wu","year":"2017","journal-title":"J Formos Med Assoc"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.01.015","article-title":"Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism","volume":"45","author":"Milliez","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/S2213-8587(17)30319-4","article-title":"Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis","volume":"6","author":"Monticone","year":"2018","journal-title":"Lancet Diabetes Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00630-0","article-title":"Cardiac remodeling\u2013concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum on Cardiac Remodeling","volume":"35","author":"Cohn","year":"2000","journal-title":"J Am Coll Cardiol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(04)00818-0","article-title":"Association of inappropriate left ventricular mass with systolic and diastolic dysfunction: the HyperGEN study","volume":"17","author":"de Simone","year":"2004","journal-title":"Am J Hypertens"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2008.16","article-title":"Left ventricular hypertrophy and clinical outcomes in hypertensive patients","volume":"21","author":"Ruilope","year":"2008","journal-title":"Am J Hypertens"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/080370501753400593","article-title":"Hypertensive left ventricular hypertrophy: pathophysiological and clinical issues","volume":"10","author":"Agabiti-Rosei","year":"2001","journal-title":"Blood Press"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.27.5.1039","article-title":"Changes in left ventricular anatomy and function in hypertension and primary aldosteronism","volume":"27","author":"Rossi","year":"1996","journal-title":"Hypertension"},{"key":"B10","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1177\/1470320310376424","article-title":"Factors influencing left ventricular mass regression in patients with primary aldosteronism post adrenalectomy","volume":"12","author":"Lin","year":"2011","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/JIM.0000000000000215","article-title":"The Relation Between the Degree of Left Ventricular Mass Regression and Serum Potassium Level Change in Patients With Primary Aldosteronism After Adrenalectomy","volume":"63","author":"Liao","year":"2015","journal-title":"J Investig Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200101000-00016","article-title":"Prognostic implications of the compensatory nature of left ventricular mass in arterial hypertension","volume":"19","author":"de Simone","year":"2001","journal-title":"J Hypertens 19"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.087320","article-title":"Inappropriate left ventricular mass changes during treatment adversely affects cardiovascular prognosis in hypertensive patients","volume":"49","author":"Muiesan","year":"2007","journal-title":"Hypertension"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.108.114140","article-title":"Inappropriate left ventricular mass in patients with primary aldosteronism","volume":"52","author":"Muiesan","year":"2008","journal-title":"Hypertension"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.02.006","article-title":"Reversal of myocardial fibrosis in patients with unilateral hyperaldosteronism receiving adrenalectomy","volume":"150","author":"Lin","year":"2011","journal-title":"Surgery"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-4311-1","article-title":"Refining the Definitions of Biochemical and Clinical Cure for Primary Aldosteronism Using the Primary Aldosteronism Surgical Outcome (PASO) Classification System","volume":"42","author":"Miller","year":"2018","journal-title":"World J Surg"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2013.785234","article-title":"Diagnosis and management of primary aldosteronism: an updated review","volume":"45","author":"Chao","year":"2013","journal-title":"Ann Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J Am Soc Echocardiogr"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.55.4.613","article-title":"Echocardiographic determination of left ventricular mass in man","volume":"55","author":"Devereux","year":"1977","journal-title":"Anatomic Validation Method Circ"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.31.5.1077","article-title":"Interaction between body size and cardiac workload: influence on left ventricular mass during body growth and adulthood","volume":"31","author":"de Simone","year":"1998","journal-title":"Hypertension"},{"key":"B21","doi-asserted-by":"publisher","first-page":"294594","DOI":"10.1155\/2013\/294594","article-title":"Twenty-four-hour urinary aldosterone predicts inappropriate left ventricular mass index in patients with primary aldosteronism","volume":"2013","author":"Hung","year":"2013","journal-title":"Sci World J"},{"key":"B22","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1161\/01.HYP.9.2_Pt_2.II19","article-title":"Detection of left ventricular hypertrophy by M-mode echocardiography","volume":"9","author":"Devereux","year":"1987","journal-title":"Anatomic Validation Standardization Comparison Other Methods Hypertension"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2001.113218","article-title":"Prognostic implications of left ventricular hypertrophy","volume":"141","author":"Vakili","year":"2001","journal-title":"Am Heart J"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(03)01018-5","article-title":"Changes in cardiovascular risk by reduction of left ventricular mass in hypertension: a meta-analysis","volume":"16","author":"Verdecchia","year":"2003","journal-title":"Am J Hypertens"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.19.2350","article-title":"Prognostic significance of left ventricular mass change during treatment of hypertension","volume":"292","author":"Devereux","year":"2004","journal-title":"JAMA"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfi190","article-title":"The role of non-haemodynamic factors of the genesis of LVH","volume":"20","author":"Schmieder","year":"2005","journal-title":"Nephrol Dial Transplant"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hps006","article-title":"Association of aldosterone with left ventricular mass in hypertension: interaction with plasma fibrinogen levels","volume":"26","author":"Catena","year":"2013","journal-title":"Am J Hypertens"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpv104","article-title":"Association of Post-Saline Load Plasma Aldosterone Levels With Left Ventricular Hypertrophy in Primary Hypertension","volume":"29","author":"Catena","year":"2016","journal-title":"Am J Hypertens"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.34.5.1032","article-title":"Ambulatory blood pressure and metabolic abnormalities in hypertensive subjects with inappropriately high left ventricular mass","volume":"34","author":"Palmieri","year":"1999","journal-title":"Hypertension"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000034740.99323.8A","article-title":"Prognosis of inappropriate left ventricular mass in hypertension: the MAVI Study","volume":"40","author":"de Simone","year":"2002","journal-title":"Hypertension"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.095448","article-title":"Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism","volume":"50","author":"Catena","year":"2007","journal-title":"Hypertension"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2010.02462.x","article-title":"The association of serum potassium level with left ventricular mass in patients with primary aldosteronism","volume":"41","author":"Lin","year":"2011","journal-title":"Eur J Clin Invest"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2014.05.062","article-title":"Association between urine aldosterone and diastolic function in patients with primary aldosteronism and essential hypertension","volume":"47","author":"Chang","year":"2014","journal-title":"Clin Biochem"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.17505","article-title":"The relationship among cardiac structure, dietary salt and aldosterone in patients with primary aldosteronism","volume":"8","author":"Hung","year":"2017","journal-title":"Oncotarget"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.10975","article-title":"The Association between Glomerular Hyperfiltration and Left Ventricular Structure and Function in Patients with Primary Aldosteronism","volume":"12","author":"Liao","year":"2015","journal-title":"Int J Med Sci"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.646097\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T17:26:56Z","timestamp":1618853216000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.646097\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,19]]},"references-count":35,"alternative-id":["10.3389\/fendo.2021.646097"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2021.646097","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,19]]},"article-number":"646097"}}