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Effect of Cushing's syndrome - Endogenous hypercortisolemia on cardiovascular autonomic functions

V P Jyotsna1, Ali Naseer, V Sreenivas

  • 1Dept. of Endocrinology, All India Institute of Medical Sciences, New Delhi, India. vivekapjyotsna@yahoo.com

Autonomic Neuroscience : Basic & Clinical
|December 24, 2010
PubMed

Insights

Cushing's syndrome impairs cardiovascular autonomic function, particularly sympathetic responses. Curative surgery shows a trend toward improving these functions, highlighting the impact of hypercortisolism on heart health.

Area of Science:

  • Endocrinology
  • Cardiology
  • Autonomic Neuroscience

Background:

  • Cushing's syndrome (CS) is linked to elevated cardiovascular morbidity and mortality.
  • CS is associated with cardiovascular risk factors including hypertension, diabetes mellitus, and obesity.
  • Impaired cardiovascular autonomic function may predict adverse cardiovascular outcomes.

Purpose of the Study:

  • To investigate cardiovascular autonomic function in patients with Cushing's syndrome.
  • To compare autonomic function between CS patients and healthy controls.
  • To assess the impact of curative surgery on autonomic function in CS.

Main Methods:

  • Twenty-five CS patients (without diabetes) and 25 age-matched controls underwent autonomic function tests.
  • Tests included deep breathing, Valsalva, hand grip, cold pressor, and postural response.
  • Seven CS patients were re-tested 6 months post-surgery.

Main Results:

  • CS patients showed significantly reduced diastolic blood pressure response during hand grip and cold pressor tests compared to controls.
  • The expiratory to inspiratory (E:I) ratio during deep breathing was significantly lower in CS patients.
  • Post-surgery, a trend toward normalization was observed, with improved E:I ratio and sinus arrhythmia delta heart rate.

Conclusions:

  • Chronic endogenous hypercortisolism in Cushing's syndrome is associated with impaired sympathetic cardiovascular autonomic function.
  • Curative surgery for CS may lead to partial recovery of autonomic cardiovascular regulation.

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