Hypokalemia as a typical feature of primary aldosteronism (PA) is associated with muscle weakness and could contribute to lower cardio pulmonary fitness. The aim of this study was to describe cardiopulmonary fitness and exercise blood pressure and their determinants during a symptom-limited exercise stress test in patients with PA. We performed a cross-sectional study of patients with confirmed PA who were included before adrenal vein sampling on whom a symptom-limited exercise stress test with expired gas analysis was performed. Patients were switched to the treatment with doxazosin and verapamil at least tw o weeks befor e the study. In 27 patients (17 male) the VO 2peak was 25.4± 6.0 ml/k g/min which corresponds to 80.8 ±18.9 % of Czech national norm. Linear regression analysis shows that VO 2peak de pends on doxazosin dose (DX) (p=0.001) and kal emia (p= 0.02): VO 2peak = 4.2 - 1.0 * DX + 7.6 * Ka lemia. Patients with higher doxazosin doses had a longer history of hypertension and had used more antihypertensives before examination, thus indicating that VO 2peak also depends on the severity of hypertension. In patients with PA, lower cardiopulmonary fitness depends inversely on the severity of hypertension and o n lower plasma potassium level., V. Tuka, M. Matoulek, T. Zelinka, J. Rosa, O. Petrák, O. Mikeš, Z. Krátká, B. Štrauch, R. Holaj, J. Widimský Jr., and Obsahuje bibliografii
Primary aldosteronism (PA) is associated with objectively measured lower physical fitness and blunted response of the renin-angiotensin-aldosterone system to exercise. The purpose of this pilot study was to objectively measure exercise response of the renin-angiotensin-aldosterone system and cardiopulmonary fitness changes after laparoscopic adrenalectomy (ADE) in patients with unilateral PA. We examined a total of 14 patients with confirmed PA before and after ADE, by means of spiroergometry and hormonal evaluation. As expected, after adrenalectomy basal aldosterone (Aldo) levels before exercise decreased significantly, with a concomitant increase in plasma renin (PR). The increase in Aldo (285.9±171.3 to 434.1± 278.2 ng/l; p=0.02) and blunted increase in PR (7.1±0.4 to 8.9±10.4 pg/ml; NS) post-exercise before ADE became significant after ADE Aldo post-ADE (46.8±18.8 to 106.5± 68.1 ng/l; p<0.0001) and PR post-ADE (20.1±14.5 to 33.9± 30.7 pg/ml; p=0.014). After adrenalectomy, the patients had a non-significant increase in peak workload and VO2peak. We found normalization of the renin-angiotensin-aldosterone system response to exercise with little changes in cardiopulmonary fitness six months after ADE., V. Tuka, M. Matoulek, J. Rosa, O. Petrák, O. Mikeš, Z. Krátká, B. Štrauch, R. Holaj, T. Zelinka, J. Widimský., and Seznam literatury