Cardiovascular status in endogenous cortisol excess: the prospective CV-CORT-EX study

Area of Science:

• Endocrinology
• Cardiology
• Internal Medicine

Background:

• Cushing's syndrome (CS) is linked to increased cardiovascular (CV) risks.
• Subtype differences and reversibility of CV issues after cure are understudied.

Purpose of the Study:

• To evaluate cardiovascular status in different forms of endogenous cortisol excess.
• To investigate reversibility of cardiac changes after biochemical cure in CS.

Main Methods:

• Prospective cohort study comparing overt CS, biochemically cured CS, and mild autonomous cortisol secretion (MACS) patients.
• Comprehensive biochemical, metabolic, and CV assessments, including echocardiography.
• Comparison with a general population sample.

Main Results:

• Overt CS shows left ventricular remodeling, hypertrophy, and impaired function.
• Cardiac alterations partially improved after cure, with persistent hypertension and hyperglycemia.
• Previous CS patients had worse diastolic function than the general population.
• MACS patients exhibited pronounced cardiac remodeling.

Conclusions:

• Overt CS, cured CS, and MACS patients exhibit significant cardiac deviations from the general population.
• Glucocorticoid excess, even mild, causes persistent cardiac alterations.
• Cardiac damage may not fully reverse despite long-term biochemical remission.