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Clinical relevance of cardiac structure and function abnormalities in patients with Cushing's syndrome before and

Paola M Toja1, Giovanna Branzi, Francesca Ciambellotti

  • 1Ospedale San Luca, Neuroendocrinology Research Lab, Istituto Auxologico Italiano IRCCS, Via Zucchi 18, Cusano Milanino, Milan, Italy.

Clinical Endocrinology
|August 23, 2011
PubMed

Insights

Cushing's syndrome causes cardiac abnormalities, particularly in left ventricular mass, which improve but persist after treatment. Heart function remains largely normal in affected patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Internal Medicine

Background:

  • Sustained hypercortisolism in Cushing's syndrome is linked to cardiac disease and mortality.
  • Cardiac structure and function alterations are clinically relevant in Cushing's syndrome management.

Purpose of the Study:

  • To evaluate cardiac structure and function using echocardiography in active Cushing's syndrome.
  • To assess changes in cardiac parameters after Cushing's syndrome remission.

Main Methods:

  • Echocardiography was performed on 71 patients with Cushing's syndrome and 70 controls.
  • Cardiac assessments were done in 49 active patients and 44 post-remission patients (median follow-up 46.4 months).
  • Prevalence of abnormal left ventricular mass and function indices was compared across groups.

Main Results:

  • 70% of active Cushing's syndrome patients had abnormal left ventricular mass (42% hypertrophy, 23% remodelling).
  • Systolic (ejection fraction) and diastolic (E/A ratio) functions were generally normal.
  • Left ventricular mass improved post-remission but remained higher than in controls; cortisol and hypertension contribute to cardiac changes.

Conclusions:

  • Cushing's syndrome increases the risk of cardiac mass abnormalities, which partially resolve after remission.
  • Despite cardiac mass changes, systolic and diastolic functions remain largely normal in Cushing's syndrome patients.
Abstract

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