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Published on: August 17, 2022
Coronary microvascular function in patients with Cushing's syndrome
Francesco Fallo1, Giulia Famoso, Dario Capizzi
1Department of Medicine, University of Padova, Via Giustiniani 2, 35128, Padua, Italy. francesco.fallo@unipd.it
Endocrine
|August 2, 2012
Summary
Coronary microvascular function is reduced in Cushing's syndrome patients, even without heart disease symptoms. This early coronary abnormality may be linked to comorbidities and potentially urinary cortisol levels.
Area of Science:
- Cardiology
- Endocrinology
- Vascular Biology
Background:
- Cushing's syndrome (CS) is characterized by prolonged exposure to excess cortisol, leading to cardiovascular complications.
- Coronary microvascular dysfunction is an early indicator of cardiovascular disease, but its prevalence in CS is not well-established.
- Assessing coronary flow reserve (CFR) provides insight into microvascular function.
Purpose of the Study:
- To evaluate coronary flow reserve (CFR) in patients with newly diagnosed Cushing's syndrome.
- To determine if CS is associated with impaired coronary microvascular function.
- To explore the relationship between urinary cortisol levels and CFR in CS patients.
Main Methods:
- Transthoracic Doppler echocardiography was used to measure coronary flow velocity at rest and during adenosine-induced hyperemia.
- Coronary flow reserve (CFR) was calculated as the ratio of hyperemic to resting diastolic flow velocity.
- Multi-slice computed tomographic coronary angiography excluded epicardial coronary stenosis in patients with reduced CFR.
Main Results:
- A reduced CFR (≤ 2.5) was observed in 33% of CS patients and 27% of controls.
- No epicardial coronary artery disease was detected in CS patients with abnormal CFR.
- CFR was inversely correlated with urinary cortisol levels in CS patients (Spearman's rho = -0.57, P = 0.03).
Conclusions:
- Coronary microvascular function is pathologically reduced in a significant number of CS patients, independent of epicardial coronary artery lesions.
- Comorbidities may contribute to early coronary abnormalities in both CS patients and matched controls.
- Further research is needed to confirm urinary cortisol as a predictor of coronary microvascular function in Cushing's syndrome.
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