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Cardiac structure and function in Cushing's syndrome: a cardiac magnetic resonance imaging study

Peter Kamenický1, Alban Redheuil, Charles Roux

  • 1Faculté de Médecine (P.K., S.S., S.B., J.Y., P.C.), Univ Paris-Sud, F-94276 Le Kremlin Bicêtre, France; Faculté de Médecine (A.R., N.K.), Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, F75006 Paris, France; Faculté de Médecine (E.M.), Université Paris Descartes, F75006 Paris, France; Service d'Endocrinologie et des Maladies de la Reproduction (P.K., S.S., J.Y., P.C.) and Service de Pharmacogénétique (S.B.), Biochimie Moléculaire et Hormonologie, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, F-94275 Le Kremlin Bicêtre, France; Département d'Imagerie Cardiovasculaire (A.R.) and Service d'Endocrinologie (C.J.), Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, F75013 Paris, France; Service de Radiologie Cardiovasculaire (C.R., L.M., A.A., Z.R., E.M.), Hôpital Européen George Pompidou, Assistance Publique-Hôpitaux de Paris, F75015 Paris, France; Service d'Endocrinologie (L.G.), Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, F75006 Paris, France; U693 (P.K., J.Y., S.B., P.C.), Institut National de la Santé et de la Recherche Médicale (INSERM), F-94276 Le Kremlin Bicêtre, France; Unité Mixte de Recherche 7371 and Unité Mixte de Recherche en Santé 1146 (A.R., N.K.), Laboratoire d'Imagerie Biomédicale, ICAN Imaging Core Lab, INSERM, F-75013 Paris, France.

The Journal of Clinical Endocrinology and Metabolism
|August 6, 2014
PubMed

Insights

Cushing's syndrome causes subclinical heart dysfunction in the left ventricle, right ventricle, and left atrium. Treatment of hypercortisolism reverses these cardiac issues, improving heart function.

Area of Science:

  • Cardiology
  • Endocrinology
  • Cardiovascular Imaging

Background:

  • Cushing's syndrome is linked to left ventricular hypertrophy and dysfunction.
  • Echocardiography may be inaccurate in obese patients, and data on right ventricular and left atrial function are lacking.

Purpose of the Study:

  • To evaluate left ventricular (LV), right ventricular (RV), and left atrial (LA) structure and function in Cushing's syndrome patients.
  • Utilize cardiac magnetic resonance (CMR) as the reference standard for cardiac assessment.

Main Methods:

  • Cardiac magnetic resonance (CMR) imaging of 18 Cushing's syndrome patients and 18 matched controls.
  • Repeat CMR imaging 6 months post-treatment for hypercortisolism.

Main Results:

  • Cushing's patients exhibited lower LV, RV, and LA ejection fractions and increased LV thickness compared to controls.
  • Treatment improved LV ejection fraction by 15%, LA ejection fraction by 45%, and RV ejection fraction by 11%.
  • LV mass index decreased by 17% post-treatment; no myocardial scarring was observed.

Conclusions:

  • Cushing's syndrome is associated with reversible biventricular and left atrial systolic dysfunction.
  • Increased LV mass in Cushing's syndrome patients is reversible after correcting hypercortisolism.
Abstract

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