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Cardiovascular autonomic function in Cushing's syndrome

F Fallo1, P Maffei, A Dalla Pozza

  • 1Department of Medical and Surgical Sciences, University of Padua, 35128 Padua, Italy. francesco.fallo@unipd.it

Journal of Endocrinological Investigation
|April 2, 2009
PubMed

Insights

Patients with Cushing's syndrome exhibit sympathovagal imbalance, with increased parasympathetic activity. This cardiac autonomic dysfunction may contribute to their high cardiovascular risk.

Area of Science:

  • Cardiology
  • Endocrinology
  • Autonomic Neuroscience

Background:

  • Cardiac autonomic dysfunction is a known predictor of cardiovascular mortality.
  • Cushing's syndrome presents a high cardiovascular risk, yet its impact on sympathovagal balance remains uncharacterized.
  • Understanding autonomic function in Cushing's syndrome is crucial for managing cardiovascular complications.

Purpose of the Study:

  • To investigate sympathovagal balance in patients with newly diagnosed Cushing's syndrome.
  • To compare cardiac autonomic function between Cushing's syndrome patients and matched controls.
  • To explore potential correlations between autonomic alterations and cardiovascular parameters in Cushing's syndrome.

Main Methods:

  • Evaluated cardiac autonomic function using 24-hour heart rate variability (HRV) analysis in frequency domain (LF/HF ratio).
  • Conducted 24-hour ambulatory blood pressure monitoring and echocardiography.
  • Compared 10 Cushing's syndrome patients with 10 age, sex, and BMI-matched controls.

Main Results:

  • Cushing's syndrome patients displayed a significantly lower LF/HF ratio, indicating reduced sympathetic and/or increased parasympathetic activity.
  • Patients with Cushing's syndrome showed elevated high-frequency (HF) power, suggesting increased parasympathetic modulation, despite similar low-frequency (LF) power.
  • Cushing's patients exhibited a higher prevalence of non-dipping blood pressure, increased left ventricular mass index, and impaired diastolic function.

Conclusions:

  • Newly diagnosed Cushing's syndrome is associated with sympathovagal imbalance, characterized by relatively increased parasympathetic activity.
  • This autonomic dysfunction may contribute to the heightened cardiovascular risk observed in Cushing's syndrome.
  • The precise pathophysiological role of this autonomic alteration in Cushing's syndrome requires further investigation.

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