Relationships between left ventricular mass and the renin–angiotensin system, catecholamines, insulin and leptin

• Published in: Journal of internal medicine Vol. 252; no. 5; pp. 430 - 439
• Main Authors: Malmqvist, K., Öhman, K. P., Lind, L., Nyström, F., Kahan, T.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-11-2002; Blackwell Science; Blackwell Publishing Ltd
• Subjects: Adult; Aged; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Glucose - analysis; blood pressure; Blood Pressure - physiology; Cardiology. Vascular system; catecholamines; Catecholamines - blood; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Echocardiography - methods; Female; Heart Rate - physiology; Homeostasis; Humans; Hypertension - blood; Hypertrophy, Left Ventricular - blood; insulin; Insulin - blood; left ventricular hypertrophy; leptin; Leptin - blood; Male; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Renin-Angiotensin System - physiology; renin–angiotensin–aldosterone system; Sympathetic Nervous System - physiology; Human; Hypertension; Pathophysiology; Biological marker; Cardiovascular disease; Exploration; Catecholamine; Sympathetic nervous system; Insulin; Left ventricle; Mass; Renin angiotensin system; Heart disease; Leptin; Diagnosis; Hemodynamics; Hypertrophy; Research Support; Non-U.S. Gov't; Left Ventricular/blood
• ISSN: 0954-6820; 1365-2796; 1365-2796
• DOI: 10.1046/j.1365-2796.2002.01053.x

. Malmqvist K, Öhman KP, Lind L, Nyström F, Kahan T (Karolinska Institutet Danderyd Hospital, Stockholm; Faculty of Health Sciences, Linköping; University Hospital, Uppsala, Sweden). Relationships between left ventricular mass and the renin–angiotensin system, catecholamines, insulin and leptin. Journal of Internal Medicine 2002; 252: 430–439.
Objectives. Several neurohormonal systems have been suggested to stimulate myocardial cell growth, and thus take part in the development of left ventricular (LV) hypertrophy. We studied associations between LV mass and markers of the renin–angiotensin–aldosterone system (RAAS), the sympathetic nervous system, glucose homeostasis and leptin.
Design. A total of 115 hypertensive patients with LV hypertrophy and two age‐ and gender‐matched control groups consisting of 38 hypertensive patients without LV hypertrophy and 38 normotensive subjects were included. We examined determinants of the RAAS, plasma levels and 24‐h urinary excretions of noradrenaline and adrenaline, plasma proinsulin, insulin, glucose, leptin and LV mass by echocardiography.
Results. Plasma renin activity (PRA) and serum aldosterone were higher (both P < 0.001) in the LV hypertrophy group than in patients without LV hypertrophy and normotensive subjects (1.0 ± 0.8, 0.2 ± 0.2 and 0.2 ± 0.2 ng mL−1 h−1, and 327 ±126, 269 ± 146 and 221 ± 80 pmol L−1, respectively). PRA and aldosterone both related (P < 0.001) to LV mass index (r = 0.44 and 0.27, respectively). Catecholamine levels and excretions were similar in all three groups and did not relate to LV mass index. Proinsulin, insulin and leptin levels were all elevated in the hypertensive patients (P < 0.01), but proinsulin, insulin, insulin sensitivity (by the homeostasis model assessment) and leptin did not relate to LV geometry, when indexed for body size.
Conclusions. Plasma renin activity and serum aldosterone levels are elevated in hypertensive LV hypertrophy and relate to LV mass index. In addition to blood pressure, activation of the RAAS may be an important nonhaemodynamic mechanism in the control of LV hypertrophy.