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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Tomaschitz, A; Piecha, G; Ritz, E; Meinitzer, A; Haas, J; Pieske, B; Wiecek, A; Rus-Machan, J; Toplak, H; März, W; Verheyen, N; Gaksch, M; Amrein, K; Kraigher-Krainer, E; Fahrleitner-Pammer, A; Pilz, S.
Marinobufagenin in essential hypertension and primary aldosteronism: a cardiotonic steroid with clinical and diagnostic implications.
Clin Exp Hypertens. 2015; 37(2):108-15 Doi: 10.3109/10641963.2014.913604
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Führende Autor*innen der Med Uni Graz
Tomaschitz Andreas
Co-Autor*innen der Med Uni Graz
Amrein Karin
Fahrleitner-Pammer Astrid
Haas Josef
Keppel Martin Helmut
Kraigher-Krainer Elisabeth
März Winfried
Meinitzer Andreas
Pieske Burkert Mathias
Pilz Stefan
Toplak Hermann
Verheyen Nicolas Dominik
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Abstract:
BACKGROUND: The cardiotonic steroid marinobufagenin (MBG) is increasingly suggested to be responsible for some of the cardiovascular injury that has been previously attributed to aldosterone. We examined the clinical correlates of circulating MBG concentrations in hypertensive patients and tested the hypothesis that MBG serves as a reliable diagnostic tool for detecting primary aldosteronism (PA). METHODS: Plasma MBG concentrations (mean: 0.51±0.25 nmol/l) were measured in the morning fasting samples in 20 patients with PA and 20 essential hypertensive (EH) controls matched for age, sex, body mass index, renal function, urinary sodium and intake of antihypertensive medication (mean age: 51.6 years; 52.2% women). RESULTS: Overall, plasma MBG was directly correlated with plasma aldosterone, aldosterone to active renin ratio (AARR), diastolic blood pressure, mean carotid intima-media thickness, serum sodium, urinary protein to creatinine ratio and inversely with serum potassium levels. Plasma MBG levels were significantly higher in patients with PA compared to EH (mean: 0.68±0.12 versus 0.35±0.24 nmol/l; p<0.001). ROC analysis yielded a greater AUC for plasma MBG compared to the AARR, PAC and serum potassium levels for detecting PA. Youden's Index analyses yielded the optimal plasma MBG cut-off score for diagnosing PA at >0.49 nmol/l with specificity and sensitivity values of 0.85 and 0.95, respectively, which were higher than those at the optimum AARR cut-off at >3.32 ng/dl/µU/ml. CONCLUSIONS: In a well-characterized cohort, values of plasma MBG were significantly related to clinical correlates of cardiovascular and renal disease. Plasma MBG emerged as a valuable alternative to the AARR for screening of PA.
Find related publications in this database (using NLM MeSH Indexing)
Aldosterone - blood
Blood Pressure - drug effects
Bufanolides - pharmacokinetics, therapeutic use
Carotid Intima-Media Thickness - administration & dosage
Essential Hypertension - administration & dosage
Female - administration & dosage
Follow-Up Studies - administration & dosage
Humans - administration & dosage
Hyperaldosteronism - blood, drug therapy, physiopathology
Hypertension - blood, drug therapy, physiopathology
Male - administration & dosage
Middle Aged - administration & dosage
Renin - blood
Retrospective Studies - administration & dosage
Treatment Outcome - administration & dosage
Vasoconstrictor Agents - pharmacokinetics, therapeutic use

Find related publications in this database (Keywords)
Aldosterone
cardiovascular
hypertension
marinobufagenin
primary aldosteronism
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