Prolongation of the QT interval in primary aldosteronism

Abstract

1. Only limited information is available concerning the changes in the electrocardiogram in primary aldosteronism. The aim of the present study was to determine factors influencing the QTc interval in patients with primary aldosteronism. 2. Nineteen patients with primary aldosteronism caused by a Conn's adenoma and 69 patients with essential hypertension, in whom all possible causes of secondary hypertension had been excluded, were included in the present study. Before and 10-20 days after adrenalectomy, blood and electrocardiographic examinations were conducted. 3. Systolic and diastolic blood pressures in primary aldosteronism were found to be comparable to those in essential hypertension. However, the QTc interval was significantly prolonged and serum potassium concentrations were significantly decreased in patients with primary aldosteronism compared with patients with essential hypertension (492.7+/-20.3 vs 428.5+/-3.1 msec for QTc interval, respectively (P<0.01); 3.07+/-0.12 vs 4.07+/-0.05 mEq/L for serum potassium concentrations, respectively (P<0.01)). The QTc interval was significantly correlated with serum potassium concentrations in primary aldosteronism (P=0.0011; r=-0.6902), but not in patients with essential hypertension. 4. Blood pressure significantly decreased after adrenalectomy. Furthermore, serum potassium concentrations increased significantly and did not correlate with the QTc interval after adrenalectomy (P=0.54; r=-0.1500). 5. Our results indicate that the QTc interval is prolonged in patients with primary aldosteronism, probably owing to hypokalaemia.

Ventricular repolarization before and after treatment in patients with secondary hypertension due to renal-artery stenosis and primary aldosteronism

“…After adrenalectomy, QT intervals shorten in patients with Conn's adenoma. 26 The effect of drug therapy on QT interval in PA had not been studied before, although aldosterone-blockers were shown to improve QT dispersion in patients with heart failure, 27 and reduce the risk of sudden death from cardiac causes in severe heart failure 28 and after myocardial infarction. 29 A limitation of the study was the small number of RV patients.…”

Effects of hypokalemia and left ventricular hypertrophy on QT interval in patients with primary aldosteronism

“…However, it remains to be controversial whether QT interval is associated with serum potassium level in patients with primary aldosteronism. Matsumura et al previously reported that QTc interval significantly correlated with serum potassium level, but did not with PAC in 19 patients with primary aldosteronism [6]. They also showed that this correlation disappeared after adrenalectomy.…”

“…Compared to patients with similar levels of hypertension, patients with primary aldosteronism have greater left ventricular hypertrophy (LVH) and increased rate of cardiovascular complications [3][4][5]. QT interval prolongation, which may increase the risk of lifethreatening arrhythmias, is also often found in primary aldosteronism [6,7]. QT interval prolongation can result from hypokalemia as well as LVH [8][9][10].…”

Male Pseudohermaphroditism Presented with Sudden Cardiac Arrest

“…In gonads, the absence of 17α-hydroxylase activity prohibits the synthesis of androgens, causing pseudohermaphroditism in males and sexual infantilism with primary hypogonadism in females 2. Aldosterone excess with subsequent hypokalemia leads to the prolongation of the QT interval,3,4 which may increase the risk of fatal arrhythmias such as polymorphic ventricular tachycardia (Torsades de Pointes), although these are very rare in subjects with hyperaldosteronism. We report a case of male pseudohermaphroditism due to 17α-hydroxylase deficiency presented with malignant arrhythmias, Torsades de Pointes.…”