Plasma renin levels are associated with cardiac function in primary adrenal insufficiency
Background Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, primary adrenal insufficiency (AI) is associated with an increased mortality, mainly due to cardiovascular disease. The role of MC replacement is not known. Therefore, we assessed whether renin concentrat...
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| Veröffentlicht in: | Endocrine 2019-08, Vol.65 (2), p.399-407 |
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| creator | Wolf, Peter Beiglböck, Hannes Fellinger, Paul Pfleger, Lorenz Aschauer, Stefan Gessl, Alois Marculescu, Rodrig Trattnig, Siegfried Kautzky-Willer, Alexandra Luger, Anton Winhofer, Yvonne Krššák, Martin Krebs, Michael |
| description | Background
Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, primary adrenal insufficiency (AI) is associated with an increased mortality, mainly due to cardiovascular disease. The role of MC replacement is not known. Therefore, we assessed whether renin concentrations during routine GC and MC substitution therapy are associated with heart function and morphology.
Methods
Thirty two patients with primary AI were included in a cross-sectional case–control study. In total, 17 patients and 34 healthy controls (age: 48 ± 12 vs. 46 ± 18 years; BMI: 23 ± 3 vs. 24 ± 3 kg/m
2
) underwent magnetic resonance spectroscopy and imaging measurements to assess cardiac function, morphology, ectopic lipids, and visceral/subcutaneous fat mass. Patients were divided according to their actual plasma renin concentration at the study visit (Actual-Renin
low
vs. Actual-Renin
high
) and their median plasma renin concentration of previous visits (Median-Renin
low
vs. Median-Renin
high
).
Results
Ejection fraction was higher (67 ± 5 vs. 55 ± 3%;
p
= 0.001) and left ventricular mass was lower (60 ± 9 vs. 73 ± 10 g/m
2
;
p
= 0.025) in Actual-Renin
high
. Median-Renin
high
was associated with lower cardiac mass (64 ± 9 vs. 76 ± 11 g/m
2
;
p
= 0.029). Blood pressure, glucose, and lipid metabolism, as well as ectopic lipid content, pericardial fat mass, and visceral/subcutaneous fat were not different between the groups. Compared with controls, ejection fraction was significantly lower in patients with AI (56 ± 4 vs. 63 ± 8%;
p
= 0.019). No differences were found in patients with ≤20 mg compared with >20 mg of hydrocortisone per day.
Conclusions
Higher renin concentrations are associated with more favorable cardiac function and morphology in patients with primary AI. |
| doi_str_mv | 10.1007/s12020-019-01974-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6656897</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2264209323</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3891-4ca5403728df66e991608116d0975058933bd904bc9da721b2e5ff8180aa01033</originalsourceid><addsrcrecordid>eNp9kT1PHDEQhq0oUSCEP0CBLKWh2WRsr7-aSBGCEAkpFCCRyprzesFoz0vsXRD_Hh93QJIiheWPeeadGb-E7DH4zAD0l8I4cGiA2dXSbcPekG0m5eoK8LaehZQNgLncIh9KuQHgnCv9nmwJxrRuebtNfp0NWJZIc0gx0SHchaFQzIFiKaOPOIWO3sfpmnrMXURP-zn5KY6JVvw2xyXmB4pdTcehPpW576OPIfmHj-Rdj0MJu5t9h1wcH50fnjSnP7__OPx22nhhLGtaj7IFobnpeqWCtUyBYUx1YLUEaawQi85Cu_C2Q83ZggfZ94YZQKxjCrFDvq51b-fFMnQ-pCnj4Da9uRGj-zuS4rW7Gu-cUlIZq6vAwUYgj7_nUCa3jMWHYcAUxrm4-mctByv4qtanf9Cbcc519CdKCG0UqErxNeXzWEoO_UszDNzKObd2zlXX3JNzjtWk_T_HeEl5tqoCYg2UGkpXIb_W_o_sIwxzo-g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2263378606</pqid></control><display><type>article</type><title>Plasma renin levels are associated with cardiac function in primary adrenal insufficiency</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Wolf, Peter ; Beiglböck, Hannes ; Fellinger, Paul ; Pfleger, Lorenz ; Aschauer, Stefan ; Gessl, Alois ; Marculescu, Rodrig ; Trattnig, Siegfried ; Kautzky-Willer, Alexandra ; Luger, Anton ; Winhofer, Yvonne ; Krššák, Martin ; Krebs, Michael</creator><creatorcontrib>Wolf, Peter ; Beiglböck, Hannes ; Fellinger, Paul ; Pfleger, Lorenz ; Aschauer, Stefan ; Gessl, Alois ; Marculescu, Rodrig ; Trattnig, Siegfried ; Kautzky-Willer, Alexandra ; Luger, Anton ; Winhofer, Yvonne ; Krššák, Martin ; Krebs, Michael</creatorcontrib><description>Background
Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, primary adrenal insufficiency (AI) is associated with an increased mortality, mainly due to cardiovascular disease. The role of MC replacement is not known. Therefore, we assessed whether renin concentrations during routine GC and MC substitution therapy are associated with heart function and morphology.
Methods
Thirty two patients with primary AI were included in a cross-sectional case–control study. In total, 17 patients and 34 healthy controls (age: 48 ± 12 vs. 46 ± 18 years; BMI: 23 ± 3 vs. 24 ± 3 kg/m
2
) underwent magnetic resonance spectroscopy and imaging measurements to assess cardiac function, morphology, ectopic lipids, and visceral/subcutaneous fat mass. Patients were divided according to their actual plasma renin concentration at the study visit (Actual-Renin
low
vs. Actual-Renin
high
) and their median plasma renin concentration of previous visits (Median-Renin
low
vs. Median-Renin
high
).
Results
Ejection fraction was higher (67 ± 5 vs. 55 ± 3%;
p
= 0.001) and left ventricular mass was lower (60 ± 9 vs. 73 ± 10 g/m
2
;
p
= 0.025) in Actual-Renin
high
. Median-Renin
high
was associated with lower cardiac mass (64 ± 9 vs. 76 ± 11 g/m
2
;
p
= 0.029). Blood pressure, glucose, and lipid metabolism, as well as ectopic lipid content, pericardial fat mass, and visceral/subcutaneous fat were not different between the groups. Compared with controls, ejection fraction was significantly lower in patients with AI (56 ± 4 vs. 63 ± 8%;
p
= 0.019). No differences were found in patients with ≤20 mg compared with >20 mg of hydrocortisone per day.
Conclusions
Higher renin concentrations are associated with more favorable cardiac function and morphology in patients with primary AI.</description><identifier>ISSN: 1355-008X</identifier><identifier>EISSN: 1559-0100</identifier><identifier>DOI: 10.1007/s12020-019-01974-1</identifier><identifier>PMID: 31177424</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Addison Disease - blood ; Addison Disease - diagnostic imaging ; Addison Disease - drug therapy ; Addison Disease - physiopathology ; Adrenal glands ; Adult ; Aged ; Anti-Inflammatory Agents - administration & dosage ; Blood pressure ; Body fat ; Cardiac function ; Cardiovascular diseases ; Case-Control Studies ; Cross-Sectional Studies ; Diabetes ; Endocrinology ; Female ; Glucocorticoids ; Glucose metabolism ; Heart ; Heart - diagnostic imaging ; Heart - physiopathology ; Hormone Replacement Therapy ; Humanities and Social Sciences ; Humans ; Hydrocortisone ; Hydrocortisone - administration & dosage ; Internal Medicine ; Lipid metabolism ; Magnetic resonance imaging ; Magnetic Resonance Spectroscopy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Morphology ; multidisciplinary ; Original ; Original Article ; Pilot Projects ; Renin ; Renin - blood ; Science ; Stroke Volume ; Ventricle</subject><ispartof>Endocrine, 2019-08, Vol.65 (2), p.399-407</ispartof><rights>The Author(s) 2019</rights><rights>Copyright Springer Nature B.V. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3891-4ca5403728df66e991608116d0975058933bd904bc9da721b2e5ff8180aa01033</citedby><cites>FETCH-LOGICAL-c3891-4ca5403728df66e991608116d0975058933bd904bc9da721b2e5ff8180aa01033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12020-019-01974-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12020-019-01974-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31177424$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wolf, Peter</creatorcontrib><creatorcontrib>Beiglböck, Hannes</creatorcontrib><creatorcontrib>Fellinger, Paul</creatorcontrib><creatorcontrib>Pfleger, Lorenz</creatorcontrib><creatorcontrib>Aschauer, Stefan</creatorcontrib><creatorcontrib>Gessl, Alois</creatorcontrib><creatorcontrib>Marculescu, Rodrig</creatorcontrib><creatorcontrib>Trattnig, Siegfried</creatorcontrib><creatorcontrib>Kautzky-Willer, Alexandra</creatorcontrib><creatorcontrib>Luger, Anton</creatorcontrib><creatorcontrib>Winhofer, Yvonne</creatorcontrib><creatorcontrib>Krššák, Martin</creatorcontrib><creatorcontrib>Krebs, Michael</creatorcontrib><title>Plasma renin levels are associated with cardiac function in primary adrenal insufficiency</title><title>Endocrine</title><addtitle>Endocrine</addtitle><addtitle>Endocrine</addtitle><description>Background
Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, primary adrenal insufficiency (AI) is associated with an increased mortality, mainly due to cardiovascular disease. The role of MC replacement is not known. Therefore, we assessed whether renin concentrations during routine GC and MC substitution therapy are associated with heart function and morphology.
Methods
Thirty two patients with primary AI were included in a cross-sectional case–control study. In total, 17 patients and 34 healthy controls (age: 48 ± 12 vs. 46 ± 18 years; BMI: 23 ± 3 vs. 24 ± 3 kg/m
2
) underwent magnetic resonance spectroscopy and imaging measurements to assess cardiac function, morphology, ectopic lipids, and visceral/subcutaneous fat mass. Patients were divided according to their actual plasma renin concentration at the study visit (Actual-Renin
low
vs. Actual-Renin
high
) and their median plasma renin concentration of previous visits (Median-Renin
low
vs. Median-Renin
high
).
Results
Ejection fraction was higher (67 ± 5 vs. 55 ± 3%;
p
= 0.001) and left ventricular mass was lower (60 ± 9 vs. 73 ± 10 g/m
2
;
p
= 0.025) in Actual-Renin
high
. Median-Renin
high
was associated with lower cardiac mass (64 ± 9 vs. 76 ± 11 g/m
2
;
p
= 0.029). Blood pressure, glucose, and lipid metabolism, as well as ectopic lipid content, pericardial fat mass, and visceral/subcutaneous fat were not different between the groups. Compared with controls, ejection fraction was significantly lower in patients with AI (56 ± 4 vs. 63 ± 8%;
p
= 0.019). No differences were found in patients with ≤20 mg compared with >20 mg of hydrocortisone per day.
Conclusions
Higher renin concentrations are associated with more favorable cardiac function and morphology in patients with primary AI.</description><subject>Addison Disease - blood</subject><subject>Addison Disease - diagnostic imaging</subject><subject>Addison Disease - drug therapy</subject><subject>Addison Disease - physiopathology</subject><subject>Adrenal glands</subject><subject>Adult</subject><subject>Aged</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>Blood pressure</subject><subject>Body fat</subject><subject>Cardiac function</subject><subject>Cardiovascular diseases</subject><subject>Case-Control Studies</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Glucocorticoids</subject><subject>Glucose metabolism</subject><subject>Heart</subject><subject>Heart - diagnostic imaging</subject><subject>Heart - physiopathology</subject><subject>Hormone Replacement Therapy</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Hydrocortisone</subject><subject>Hydrocortisone - administration & dosage</subject><subject>Internal Medicine</subject><subject>Lipid metabolism</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Spectroscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>multidisciplinary</subject><subject>Original</subject><subject>Original Article</subject><subject>Pilot Projects</subject><subject>Renin</subject><subject>Renin - blood</subject><subject>Science</subject><subject>Stroke Volume</subject><subject>Ventricle</subject><issn>1355-008X</issn><issn>1559-0100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kT1PHDEQhq0oUSCEP0CBLKWh2WRsr7-aSBGCEAkpFCCRyprzesFoz0vsXRD_Hh93QJIiheWPeeadGb-E7DH4zAD0l8I4cGiA2dXSbcPekG0m5eoK8LaehZQNgLncIh9KuQHgnCv9nmwJxrRuebtNfp0NWJZIc0gx0SHchaFQzIFiKaOPOIWO3sfpmnrMXURP-zn5KY6JVvw2xyXmB4pdTcehPpW576OPIfmHj-Rdj0MJu5t9h1wcH50fnjSnP7__OPx22nhhLGtaj7IFobnpeqWCtUyBYUx1YLUEaawQi85Cu_C2Q83ZggfZ94YZQKxjCrFDvq51b-fFMnQ-pCnj4Da9uRGj-zuS4rW7Gu-cUlIZq6vAwUYgj7_nUCa3jMWHYcAUxrm4-mctByv4qtanf9Cbcc519CdKCG0UqErxNeXzWEoO_UszDNzKObd2zlXX3JNzjtWk_T_HeEl5tqoCYg2UGkpXIb_W_o_sIwxzo-g</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Wolf, Peter</creator><creator>Beiglböck, Hannes</creator><creator>Fellinger, Paul</creator><creator>Pfleger, Lorenz</creator><creator>Aschauer, Stefan</creator><creator>Gessl, Alois</creator><creator>Marculescu, Rodrig</creator><creator>Trattnig, Siegfried</creator><creator>Kautzky-Willer, Alexandra</creator><creator>Luger, Anton</creator><creator>Winhofer, Yvonne</creator><creator>Krššák, Martin</creator><creator>Krebs, Michael</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201908</creationdate><title>Plasma renin levels are associated with cardiac function in primary adrenal insufficiency</title><author>Wolf, Peter ; Beiglböck, Hannes ; Fellinger, Paul ; Pfleger, Lorenz ; Aschauer, Stefan ; Gessl, Alois ; Marculescu, Rodrig ; Trattnig, Siegfried ; Kautzky-Willer, Alexandra ; Luger, Anton ; Winhofer, Yvonne ; Krššák, Martin ; Krebs, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3891-4ca5403728df66e991608116d0975058933bd904bc9da721b2e5ff8180aa01033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Addison Disease - blood</topic><topic>Addison Disease - diagnostic imaging</topic><topic>Addison Disease - drug therapy</topic><topic>Addison Disease - physiopathology</topic><topic>Adrenal glands</topic><topic>Adult</topic><topic>Aged</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>Blood pressure</topic><topic>Body fat</topic><topic>Cardiac function</topic><topic>Cardiovascular diseases</topic><topic>Case-Control Studies</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Glucocorticoids</topic><topic>Glucose metabolism</topic><topic>Heart</topic><topic>Heart - diagnostic imaging</topic><topic>Heart - physiopathology</topic><topic>Hormone Replacement Therapy</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Hydrocortisone</topic><topic>Hydrocortisone - administration & dosage</topic><topic>Internal Medicine</topic><topic>Lipid metabolism</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Spectroscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Morphology</topic><topic>multidisciplinary</topic><topic>Original</topic><topic>Original Article</topic><topic>Pilot Projects</topic><topic>Renin</topic><topic>Renin - blood</topic><topic>Science</topic><topic>Stroke Volume</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wolf, Peter</creatorcontrib><creatorcontrib>Beiglböck, Hannes</creatorcontrib><creatorcontrib>Fellinger, Paul</creatorcontrib><creatorcontrib>Pfleger, Lorenz</creatorcontrib><creatorcontrib>Aschauer, Stefan</creatorcontrib><creatorcontrib>Gessl, Alois</creatorcontrib><creatorcontrib>Marculescu, Rodrig</creatorcontrib><creatorcontrib>Trattnig, Siegfried</creatorcontrib><creatorcontrib>Kautzky-Willer, Alexandra</creatorcontrib><creatorcontrib>Luger, Anton</creatorcontrib><creatorcontrib>Winhofer, Yvonne</creatorcontrib><creatorcontrib>Krššák, Martin</creatorcontrib><creatorcontrib>Krebs, Michael</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Endocrine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wolf, Peter</au><au>Beiglböck, Hannes</au><au>Fellinger, Paul</au><au>Pfleger, Lorenz</au><au>Aschauer, Stefan</au><au>Gessl, Alois</au><au>Marculescu, Rodrig</au><au>Trattnig, Siegfried</au><au>Kautzky-Willer, Alexandra</au><au>Luger, Anton</au><au>Winhofer, Yvonne</au><au>Krššák, Martin</au><au>Krebs, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Plasma renin levels are associated with cardiac function in primary adrenal insufficiency</atitle><jtitle>Endocrine</jtitle><stitle>Endocrine</stitle><addtitle>Endocrine</addtitle><date>2019-08</date><risdate>2019</risdate><volume>65</volume><issue>2</issue><spage>399</spage><epage>407</epage><pages>399-407</pages><issn>1355-008X</issn><eissn>1559-0100</eissn><abstract>Background
Despite adequate glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy, primary adrenal insufficiency (AI) is associated with an increased mortality, mainly due to cardiovascular disease. The role of MC replacement is not known. Therefore, we assessed whether renin concentrations during routine GC and MC substitution therapy are associated with heart function and morphology.
Methods
Thirty two patients with primary AI were included in a cross-sectional case–control study. In total, 17 patients and 34 healthy controls (age: 48 ± 12 vs. 46 ± 18 years; BMI: 23 ± 3 vs. 24 ± 3 kg/m
2
) underwent magnetic resonance spectroscopy and imaging measurements to assess cardiac function, morphology, ectopic lipids, and visceral/subcutaneous fat mass. Patients were divided according to their actual plasma renin concentration at the study visit (Actual-Renin
low
vs. Actual-Renin
high
) and their median plasma renin concentration of previous visits (Median-Renin
low
vs. Median-Renin
high
).
Results
Ejection fraction was higher (67 ± 5 vs. 55 ± 3%;
p
= 0.001) and left ventricular mass was lower (60 ± 9 vs. 73 ± 10 g/m
2
;
p
= 0.025) in Actual-Renin
high
. Median-Renin
high
was associated with lower cardiac mass (64 ± 9 vs. 76 ± 11 g/m
2
;
p
= 0.029). Blood pressure, glucose, and lipid metabolism, as well as ectopic lipid content, pericardial fat mass, and visceral/subcutaneous fat were not different between the groups. Compared with controls, ejection fraction was significantly lower in patients with AI (56 ± 4 vs. 63 ± 8%;
p
= 0.019). No differences were found in patients with ≤20 mg compared with >20 mg of hydrocortisone per day.
Conclusions
Higher renin concentrations are associated with more favorable cardiac function and morphology in patients with primary AI.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31177424</pmid><doi>10.1007/s12020-019-01974-1</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Endocrine, 2019-08, Vol.65 (2), p.399-407 |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Addison Disease - blood Addison Disease - diagnostic imaging Addison Disease - drug therapy Addison Disease - physiopathology Adrenal glands Adult Aged Anti-Inflammatory Agents - administration & dosage Blood pressure Body fat Cardiac function Cardiovascular diseases Case-Control Studies Cross-Sectional Studies Diabetes Endocrinology Female Glucocorticoids Glucose metabolism Heart Heart - diagnostic imaging Heart - physiopathology Hormone Replacement Therapy Humanities and Social Sciences Humans Hydrocortisone Hydrocortisone - administration & dosage Internal Medicine Lipid metabolism Magnetic resonance imaging Magnetic Resonance Spectroscopy Male Medicine Medicine & Public Health Middle Aged Morphology multidisciplinary Original Original Article Pilot Projects Renin Renin - blood Science Stroke Volume Ventricle |
| title | Plasma renin levels are associated with cardiac function in primary adrenal insufficiency |
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