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Impaired endothelium mediated vascular reactivity in endogenous Cushing's syndrome

Dinu S Chandran1, Ashok Kumar Jaryal, Viveka P Jyotsna

  • 1Department of Physiology, All India Institute of Medical Sciences, Ansari Nagal, New Delhi, India.

Endocrine Journal
|July 23, 2011
PubMed

Insights

Endogenous Cushing's syndrome impairs vascular reactivity and endothelial function. Elevated cortisol levels are linked to this dysfunction, increasing cardiovascular risks.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Vascular Biology

Background:

  • Endogenous Cushing's syndrome (CS) is linked to high cardiovascular morbidity and mortality.
  • Multiple cardiovascular risk factors in CS likely induce endothelial dysfunction.
  • Emerging evidence suggests cortisol directly contributes to vascular dysfunction in CS.

Purpose of the Study:

  • To non-invasively assess vascular reactivity in CS patients.
  • To investigate the association between vascular reactivity and elevated cortisol levels in CS.
  • To explore the role of hypercortisolism in endothelial dysfunction in CS.

Main Methods:

  • Observational study comparing 18 CS patients with 15 healthy controls.
  • Non-invasive assessment of vascular reactivity using digital photoplethysmography (PPG) during reactive hyperemia (RH).
  • Measured pulse wave form amplitude (PWA) and pulse transit time (PTT) changes.

Main Results:

  • Maximal PWA changes during RH were significantly lower in CS patients versus controls (p=0.0079).
  • Normalized PTT responses during the first minute of RH were blunted in CS patients (p=0.0425).
  • PTT changes during the second minute of RH negatively correlated with morning cortisol levels (r=-0.6328, p=0.0064).

Conclusions:

  • Endothelium-mediated vascular reactivity and myogenic regulation of vascular tone are impaired in CS.
  • Hypercortisolism likely plays a significant role in causing impaired vascular reactivity and endothelial dysfunction in CS.
  • These findings highlight potential therapeutic targets for cardiovascular risk reduction in CS.

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