Left ventricular geometry and 24-h blood pressure profile in Cushing's syndrome

Area of Science:

• Cardiology
• Endocrinology
• Hypertension Research

Background:

• Cushing's syndrome (CS) is linked to cardiovascular disease.
• The influence of hemodynamic load on left ventricular mass (LVM) in CS patients is not fully understood.
• The impact of 24-hour blood pressure (BP) load and circadian BP rhythm on cardiac structure and function in CS remains unexamined.

Purpose of the Study:

• To investigate cardiac remodeling in newly diagnosed CS patients.
• To evaluate the association between cardiac remodeling and 24-hour BP burden using ambulatory blood pressure monitoring (ABPM).
• To assess the relationship between BP load, circadian BP patterns, and cardiac morphology in CS.

Main Methods:

• Echocardiography was used to assess cardiac morphology and geometry (relative wall thickness-RWT) in 25 CS patients.
• 25 control subjects with similar demographic characteristics and 24-hour BP were recruited.
• 24-hour ABPM was performed to evaluate BP load and circadian rhythm (dipping/non-dipping patterns).

Main Results:

• CS patients exhibited significantly increased LVM and RWT compared to controls.
• The prevalence of the non-dipping BP profile was higher in CS patients than in controls (56% vs. 16%).
• Neither 24-hour BP load nor dipping status showed a significant association with LVM or RWT in CS patients.

Conclusions:

• Newly diagnosed CS patients demonstrate cardiac remodeling, characterized by increased LVM and a concentric pattern.
• Left ventricular remodeling in CS appears to be relatively independent of the 24-hour BP load and circadian BP profile.
• Further research may be needed to elucidate other contributing factors to cardiac remodeling in CS beyond BP parameters.