A probable relationship between an endogenous digitalis-like substance andconcentric cardiac hypertrophy in primary aldosteronism

A 44-year-old woman was admitted to our hospital due to severe hypertension . An electrocardiogram (ECG) and an echocardiogram showed severe left ventr icular hypertrophy. Her plasma aldosterone level was elevated. Magnetic res onance imaging revealed a small mass in the right adrenal gland. Before rem oval of the tumor, plasma endogenous digitalis-like substance (EDLS) levels were elevated. After removal of the tumor, EDLS levels quickly returned to the normal level. A series of echocardiograms and ECGs over a 6- year peri od after removal of the tumor showed marked regression of cardiac hypertrop hy, These findings suggest that EDLS may be closely related to the developm ent of concentric cardiac hypertrophy in primary aldosteronism.