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Differences in left ventricular structural and functional changes between pheochromocytoma and essential
F M Fouad-Tarazi1, M Imamura, E L Bravo
1Department of Heart and Hypertension Research, Cleveland Clinic Foundation, OH 44195-5069.
American Journal of Hypertension
|March 1, 1992
Summary
Elevated catecholamines in pheochromocytoma do not necessarily cause cardiac hypertrophy. Other factors, not blood pressure or catecholamines, likely determine left ventricular hypertrophy development.
Area of Science:
- Cardiology
- Endocrinology
- Physiology
Background:
- Catecholamines are known to influence protein synthesis and cardiac hypertrophy.
- Pheochromocytoma is characterized by elevated circulating plasma catecholamines, potentially affecting cardiac remodeling.
Purpose of the Study:
- To investigate the influence of elevated circulating plasma catecholamines in pheochromocytoma on cardiac structural and functional remodeling.
- To compare cardiac remodeling in patients with pheochromocytoma versus essential hypertension, matched for age, sex, body surface area, and blood pressure.
Main Methods:
- Compared 15 patients with pheochromocytoma to 15 with essential hypertension.
- Utilized M-mode echocardiography to assess left ventricular hypertrophy (LVH) and other cardiac structural and functional indices.
- Measured plasma norepinephrine and epinephrine levels.
Main Results:
- No significant differences in cardiac structure or left ventricular mass were found between groups, irrespective of blood pressure.
- Plasma norepinephrine levels were higher in the pheochromocytoma group but did not correlate with LVH within that group.
- Despite higher norepinephrine, pheochromocytoma patients showed improved cardiac function (higher fractional shortening) and reduced systolic stress.
Conclusions:
- Left ventricular hypertrophy develops only in a subset of patients with both pheochromocytoma and essential hypertension.
- Elevated circulating catecholamines in pheochromocytoma are not directly associated with the development of LVH.
- Factors beyond catecholamines and blood pressure are critical determinants of LVH in pheochromocytoma.