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Heart in adrenal diseases
1IIIrd Department of Internal Medicine, Charles University, 1st School of Medicine, Prague, Czechoslovakia.
Insights
Cardiac changes in endocrine disorders like phaeochromocytoma, primary hyperaldosteronism, and Cushing syndrome were assessed using echocardiography. Echocardiographic abnormalities in these conditions resolved after treatment, indicating reversible cardiac effects.
Area of Science:
- Cardiology
- Endocrinology
- Medical Diagnostics
Background:
- Cardiac alterations in endocrine disorders are not fully understood.
- Limited literature exists on echocardiographic findings in phaeochromocytoma, primary hyperaldosteronism, and Cushing syndrome.
Purpose of the Study:
- To review existing literature on cardiac changes in these endocrine diseases.
- To present novel echocardiographic findings in patients with phaeochromocytoma, primary hyperaldosteronism, and Cushing syndrome.
Main Methods:
- Literature review on cardiac manifestations of the specified endocrine disorders.
- Echocardiographic assessment of cardiac structure and function in affected patients.
- Comparison of findings with control groups and post-treatment evaluations.
Main Results:
- Phacochromocytoma: Mild interventricular septum thickening and increased left ventricular mass without significant functional impairment.
- Primary hyperaldosteronism: Slight posterior left ventricular wall thickening and increased left ventricular mass index.
- Cushing syndrome: Tendency towards concentric left ventricular hypertrophy.
- Observed echocardiographic changes were reversible post-treatment in all conditions.
Conclusions:
- Endocrine disorders like phaeochromocytoma, primary hyperaldosteronism, and Cushing syndrome can induce subtle cardiac changes.
- Echocardiography is valuable in detecting these cardiac alterations.
- The observed cardiac changes are generally reversible upon successful treatment of the underlying endocrine condition.
Abstract:
The paper reviews the hitherto rather scarce literature concerned with cardiac changes in phaeochromocytoma, primary hyperaldosteronism and Cushing syndrome, and presents the authors' own echocardiographic findings in these diseases. In phaeochromocytoma they found a slight thickening of the interventricular septum which, however, did not fulfil the criteria of asymmetric left ventricular hypertrophy. Also other parameters showed higher values attesting to an increased left ventricular mass, however, without exceeding normal limits. Focal disturbances of left ventricular kinetics and the decrease in LV systolic function were non significant. The picture of obstructive hypertrophic cardiomyopathy, frequently mentioned in the literature, was observed only once, giving grounds to the suspicion that it is only a nonspecific manifestation of the hypercontractile state of the myocardium. In primary hyperaldosteronism only slight posterior LV wall thickening and an increase in the LV mass index were found, compared to control group. No significant changes were found in Cushing syndrome besides a tendency to concentric LV hypertrophy. Echocardiographic changes observed in all three affections disappeared after successful surgical or drug treatment.