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Ivan M. Robbins, MD; John H. Newman, MD
Author and Funding Information

From the Vanderbilt University School of Medicine.

Correspondence to: Ivan M. Robbins, MD, Vanderbilt University, 1161 21st Ave S, MCN, Room T-1218, Nashville, TN 37232; e-mail: Ivan.Robbins@vanderbilt.edu


Financial/nonfinancial disclosures: The authors has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(2):502. doi:10.1378/chest.09-2021
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To the Editor:

We thank Drs Farber, Walkey, and Alikhan for bringing to our attention the importance of aldosterone in the development of left ventricular (LV) diastolic dysfunction. The studies noted in their letter highlight the importance of metabolic derangements in the development of LV diastolic dysfunction, which can occur even in the absence of systemic hypertension or LV hypertrophy.1- 3 We did not measure aldosterone levels in our study4 but plan to do so in future studies.

There is increasing evidence that features of the metabolic syndrome are likely to contribute to the development of pulmonary hypertension in susceptible patients.5 This is an area that requires further investigation, and we were intrigued by the recent publications of Dr Farber and his colleagues about the potential role of adiponectin deficiency in the development of pulmonary hypertension.6

Rossi GP, Di Bello V, Ganzaroli C, et al. Excess aldosterone is associated with alterations of myocardial texture in primary aldosteronism. Hypertension. 2002;401:23-27. [CrossRef] [PubMed]
 
Stowasser M, Sharman J, Leano R, et al. Evidence for abnormal left ventricular structure and function in normotensive individuals with familial hyperaldosteronism type I. J Clin Endocrinol Metab. 2005;909:5070-5076. [CrossRef] [PubMed]
 
de las Fuentes L, Brown AL, Mathews SJ, et al. Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass. Eur Heart J. 2007;285:553-559. [CrossRef] [PubMed]
 
Robbins IM, Newman JH, Johnson RF, et al. Association of the metabolic syndrome with pulmonary venous hypertension. Chest. 2009;1361:31-36. [CrossRef] [PubMed]
 
Zamanian RT, Hansmann G, Snook S, et al. Insulin resistance in pulmonary arterial hypertension. Eur Respir J. 2009;332:318-324. [CrossRef] [PubMed]
 
Summer R, Fiack CA, Ikeda Y, et al. Adiponectin deficiency: a model of pulmonary hypertension associated with pulmonary vascular disease. Am J Physiol Lung Cell Mol Physiol. 2009;2973:L432-L438. [CrossRef] [PubMed]
 

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References

Rossi GP, Di Bello V, Ganzaroli C, et al. Excess aldosterone is associated with alterations of myocardial texture in primary aldosteronism. Hypertension. 2002;401:23-27. [CrossRef] [PubMed]
 
Stowasser M, Sharman J, Leano R, et al. Evidence for abnormal left ventricular structure and function in normotensive individuals with familial hyperaldosteronism type I. J Clin Endocrinol Metab. 2005;909:5070-5076. [CrossRef] [PubMed]
 
de las Fuentes L, Brown AL, Mathews SJ, et al. Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass. Eur Heart J. 2007;285:553-559. [CrossRef] [PubMed]
 
Robbins IM, Newman JH, Johnson RF, et al. Association of the metabolic syndrome with pulmonary venous hypertension. Chest. 2009;1361:31-36. [CrossRef] [PubMed]
 
Zamanian RT, Hansmann G, Snook S, et al. Insulin resistance in pulmonary arterial hypertension. Eur Respir J. 2009;332:318-324. [CrossRef] [PubMed]
 
Summer R, Fiack CA, Ikeda Y, et al. Adiponectin deficiency: a model of pulmonary hypertension associated with pulmonary vascular disease. Am J Physiol Lung Cell Mol Physiol. 2009;2973:L432-L438. [CrossRef] [PubMed]
 
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