Related Experiment Video

Updated: Jun 2, 2025

Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice
07:36

Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice

Published on: September 26, 2018

10.0K

Mineralocorticoid axis activity and cardiac remodeling in patients with ACTH-dependent Cushing's syndrome

Peter Wolf, Simon Travers, Oliver Domenig

    Endocrine Connections
    |January 13, 2025
    PubMed

    Insights

    Patients with Cushing's syndrome exhibit altered angiotensin metabolism and lower aldosterone levels, contributing to cardiovascular risks like hypertension and cardiac remodeling due to cortisol excess.

    Area of Science:

    • Endocrinology
    • Cardiovascular Medicine
    • Metabolomics

    Background:

    • Arterial hypertension and left ventricular hypertrophy are key cardiovascular risks in Cushing's syndrome.
    • The renin-angiotensin system and mineralocorticoid axis may play roles in pathogenesis, alongside cortisol excess.

    Purpose of the Study:

    • To investigate the specific profile of angiotensin metabolites and adrenal steroids in ACTH-dependent Cushing's syndrome.
    • To evaluate the relationship between these metabolites, blood pressure, and cardiac structure.

    Main Methods:

    • An ancillary study compared 11 patients with ACTH-dependent Cushing's syndrome to 20 matched controls.
    • Angiotensin metabolites and adrenal steroids were measured using liquid chromatography tandem mass spectrometry.
    • Cardiac structure was assessed via cardiac magnetic resonance imaging.

    Main Results:

    • Patients showed significantly lower angiotensin-converting enzyme activity and aldosterone concentrations compared to controls.
    • Aldosterone precursor metabolites were comparable, suggesting direct cortisol inhibition of aldosterone synthase.
    • Urinary free cortisol and aldosterone correlated inversely with left ventricular mass index.

    Conclusions:

    • ACTH-dependent Cushing's syndrome presents a distinct angiotensin metabolite profile.
    • Cortisol excess directly inhibits aldosterone synthesis and promotes cardiac remodeling.
    • These hormonal changes contribute to the cardiovascular risks observed in Cushing's syndrome.
    Abstract

    Keywords:
    Cushing’s syndromeRAS systemaldosteroneangiotensinhypertension

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