Key result
Primary aldosteronism is linked to ~6-point lower LA emptying fraction versus essential hypertension.
Why the study?
Primary aldosteronism carries an increased risk of atrial fibrillation and heart failure, motivating three-dimensional echocardiography and strain imaging to characterize left atrial remodeling and dysfunction for early identification of cardiac dysfunction.
Cross-Sectional (n=61)
Primary aldosteronism is associated with increased left atrial volume index and impaired left atrial reservoir and pump function compared to both healthy volunteers and essential hypertension patients, which may underlie their elevated risk for atrial fibrillation and heart failure.
Primary aldosteronism-linked LA impairment may heighten AF risk; extends observational data but leaves causal and therapeutic implications open.
Background As primary aldosteronism (PA) is associated with an increased risk of cardiovascular events, including atrial fibrillation and heart failure, this study utilized three-dimensional echocardiography to investigate left atrial (LA) remodeling and dysfunction, aiming for early identification of cardiac dysfunction. Methods In this cross-sectional study, 61 participants were enrolled, including 24 PA (63.00±11.88y, 54.2% male), 13 essential hypertension (EH) (68.38±8.78y, 69.2% male) and 24 healthy volunteers (62.83±7.64y, 66.6% male). Two/three-dimensional echocardiography and strain imaging were used to acquire parameters of LA structure, function, and strain, as well as left ventricular (LV) structure and function in enrolled individuals. One-way ANOVA and non-parametric tests were used to analyze inter-group differences using Stata 15.0. Results Significantly increased LA Vmin, LA Vmax, LA VpreA, and LA VImax (25.80±6.06 vs 17.54±6.30ml, 50.47±9.16 vs39.25±12.06ml, 40.40±8.84 vs 29.79±9.39ml, 32.73±16.31 vs 22.46±6.70ml/m2, all p < 0.05) and reduced LAEF, LASr_c, and LASct_c (48.93±7.97 vs 55.67±7.73%, 26.93±8.25 vs 34.75±9.74%, -17.80±5.95 vs -22.75±7.55%, all p < 0.05) were observed in PA group compared with healthy volunteers. Meanwhile, significantly lower LAEF and LASr_c (48.93±7.97 vs 55.15±4.93%, 26.93±8.25 vs 33.46±6.57%, both p < 0.05) were observed in PA group compared to the HTN group. Additionally, LV strain parameters were significantly lower in PA compared with the HTN group (-18.37±2.26 vs -20.54±3.25%, p < 0.05). Conclusions PA is associated with increased LA volume index and decreased LA reservoir and pump function. LA dysfunction may be the key pathophysiological change leading to atrial fibrillation and heart failure in PA.LA straining imaging
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Yan et al. (2026) conducted a cross-sectional in Primary aldosteronism (n=61). Primary aldosteronism vs. Essential hypertension and healthy volunteers was evaluated on Left atrial emptying fraction (LAEF) and reservoir strain (LASr_c) (p=<0.05). Primary aldosteronism was associated with reduced left atrial emptying fraction (48.93% vs 55.15%) and reservoir strain (26.93% vs 33.46%, both p<0.05) compared to essential hypertension.
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