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Impaired cardiac pumping function and increased afterload as determinants of early hemodynamic alterations in Cushing

Agnieszka Włochacz1,2, Paweł Krzesiński3, Beata Uziębło-Życzkowska3

  • 1Department of Cardiology and Internal Medicine, Military Institute of Medicine - National Research Institute, Warsaw, Poland. agnieszkajurek1@gmail.com.

Scientific Reports
|January 2, 2025
PubMed

Insights

Cushing disease (CD) is linked to heart dysfunction, showing impaired pumping and increased vascular resistance. This study reveals how hypercortisolemia affects cardiac and vascular health in newly diagnosed CD patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Physiology

Background:

  • Long-term hypercortisolemia in Cushing disease (CD) can cause hemodynamic disorders.
  • Subclinical cardiac and vascular dysfunction are potential consequences of elevated cortisol levels.

Purpose of the Study:

  • To investigate the relationship between hemodynamic parameters measured by impedance cardiography (ICG) and echocardiographic parameters of left ventricular function.
  • To assess cardiac and vascular changes in patients newly diagnosed with CD.

Main Methods:

  • Observational cohort study involving 54 newly diagnosed CD patients.
  • Impedance cardiography (ICG) was used to assess stroke volume index (SI), cardiac index (CI), acceleration index (ACI), velocity index (VI), systemic vascular resistance index (SVRI), and total artery compliance index (TACI).
  • Echocardiography evaluated left ventricular mass index (LVMI) and systolic/diastolic function parameters.

Main Results:

  • Higher LVMI correlated with lower SI, CI, VI, TACI, and higher SVRI.
  • Impaired diastolic function (lower E/A, lower average e', higher E/e') was associated with altered ICG parameters (lower SI, CI, VI, ACI, TACI; higher SVRI).
  • Decreased global longitudinal strain correlated with lower TACI.

Conclusions:

  • Cushing disease is associated with impaired cardiac pumping function.
  • Patients with CD exhibit increased systemic vascular resistance (afterload).
  • ICG and echocardiography can detect subclinical hemodynamic and cardiac alterations in CD.

Keywords:
Cushing diseaseEchocardiographyGlobal longitudinal strainHemodynamic disordersImpedance cardiographyPituitary neuroendocrine tumor

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