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Published on: July 2, 2018
[Chronic pheochromocytoma-induced myocardial injuries: What should we expect from modern and classical
R Boulestreau1, F Jambon2, A Cremer1
1Centre d'excellence en hypertension artérielle, CHU de Bordeaux, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France.
Insights
This study found no significant changes in left ventricular global longitudinal strain (GLS) in patients with chronic pheochromocytoma compared to controls. Further research is recommended to understand the cardiac impact of this rare disease.
Area of Science:
- Cardiology
- Endocrinology
- Medical Imaging
Background:
- Pheochromocytoma, a rare tumor, can cause severe cardiac complications.
- The chronic cardiac impact of pheochromocytoma is not well-defined.
- Cardiac MRI studies suggest fibrosis and myocarditis in these patients, potentially affecting left ventricular longitudinal systolic strain.
Purpose of the Study:
- To investigate alterations in left ventricular systolic strain in patients with chronic pheochromocytoma.
- To compare cardiac parameters between pheochromocytoma patients and matched controls.
Main Methods:
- Retrospective case-control study.
- Comparison of left ventricular global longitudinal strain (GLS), radial and circumferential strain, and echocardiographic parameters.
- 47 pheochromocytoma patients and 47 matched controls.
Main Results:
- No significant difference in GLS between pheochromocytoma patients and controls (-20.7±2.4% vs. -20.2±2.7%, P=0.40).
- Left ventricular ejection fraction and circumferential strain were significantly higher in patients.
- Patients had a significantly lower telediastolic diameter compared to controls.
Conclusions:
- No significant changes in GLS were observed in chronic pheochromocytoma patients.
- Cardiac MRI may be considered for patients due to potential fibrosis and myocarditis.
- Further studies are needed to clarify the long-term cardiac effects of pheochromocytoma.
Introduction:
Pheochromocytoma is a rare disease, which may manifest as severe cardiac complications. Apart from these situations, the "chronic" cardiac impact is not clearly defined. A cardiac MRI study suggests that these patients are carrying areas of fibrosis and foci of left ventricular myocarditis. Since these abnormalities are usually associated with altered left ventricular longitudinal systolic strain, we hypothesize that this strain is altered in patients with a "chronic" pheochromocytoma.
Method:
This retrospective case-control study was performed using patients from the Bordeaux University Hospital database, included between 2008 and 2016. We compared the left ventricular global longitudinal strain (GLS), radial and circumferential systolic strain and classic echocardiographic parameters between patients with pheochromocytoma and controls matched for age, sex, body mass index and systolic blood pressure.
Results:
The analysis included 47 patients and 47 correctly matched controls. There were no statistically significant differences between the 2 groups in terms of GLS (-20.7±2.4% vs. -20.2±2.7%, P=0.40), radial strain, left ventricular mass or diastolic function. Left ventricular ejection fraction and circumferential strain were significantly higher in patients than in controls, with a significantly lower telediastolic diameter.
Conclusion:
No significant changes in GLS were observed in our pheochromocytoma patients, compared with controls. Several hypotheses may explain these results. The presence of fibrosis foci and areas of left ventricular myocarditis being associated with a poor cardiological prognosis, a systematic cardiac MRI could be discussed in these patients, until further studies are performed.
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