A speckle-tracking echocardiographic study on right ventricular function in primary aldosteronism

Primary aldosteronism represents the most frequent form of secondary arterial hypertension, with prevalence more than 11% in new-onset hypertensive patients. Beyond moderate-severe hypertension, or resistant hypertension, in these patients it is frequent to observe an unfavourable metabolic profile, characterized by higher prevalence of diabetes mellitus, metabolic syndrome, with altered adipokines levels. Several reports described a higher rate of cardiovascular events in primary aldosteronism patients when compared with essential hypertensive patients, independently from blood pressure values and directly related to aldosterone excess. Previous studies showed that plasma aldosterone (PAC) excess itself, either in primary aldosteronism and in secondary aldosteronism (characterized by lack of arterial hypertension) is correlated with left ventricular enlargement and high prevalence of left ventricular hypertrophy and diastolic dysfunction; whereas subclinical systolic dysfunction, myocardial interstitial fibrosis and increased collagen deposition in the heart are evident only in the presence of PAC excess and hypertension.