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

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Abstract

Cushing’s syndrome (CS) is associated with cardiovascular disease. The impact of the hemodynamic load on left ventricular mass (LVM) in patients with CS is not well known. In fact, the effects of 24-h blood pressure (BP) load and BP circadian rhythm on cardiac structure and function have not been studied. Aim of the present study has thus been to assess the presence of cardiac remodeling in patients with newly diagnosed CS, combining evaluation of cardiac remodeling and assessment of BP burden derived by 24-h ambulatory blood pressure monitoring (ABPM). 25 patients (4 M, 21 F) with CS underwent echocardiography in order to assess cardiac morphology and geometry (relative wall thickness—RWT). As controls, 25 subjects similar for demographic characteristics and 24-h BP were used. CS Patients were similar to controls by age, sex, mean 24-h BP, and body mass index. There was a significant increase in left ventricular mass (LVM; 44.4 ± 14.7 vs. 36.9 ± 10 g/m2.7, p = 0.03) and a significant increase in RWT (0.46 ± 0.07 vs. 0.41 ± 0.08, p = 0.02) in CS patients compared to controls. The prevalence of CS patients with pressure non-dipping profile was greater than that of controls (56 vs. 16 %, p < 0.05), with no significant association with LVM or geometry. 24-h urinary cortisol was not associated with LVM (r = 0.1, p = 0.5) or RWT (r = 0.02, p = 0.89) in the CS group. In conclusion, LVM and the concentric pattern of the left ventricle are relatively independent from 24-h BP load and profile (dipping/non-dipping) in CS patients.

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Abbreviations

ABPM:

Ambulatory blood pressure monitoring

BP:

Blood pressure

CS:

Cushing’s syndrome

LVM:

Left ventricular mass

LVMi:

LVM indexed to body surface area

LVM_H2.7 :

LVM indexed to height2.7

RWT:

Relative wall thickness

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Authors and Affiliations

  1. Internal Medicine and Hypertension Division, Department of Medical Sciences, University Hospital AOU Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126, Turin, Italy

    Eleonora Avenatti, Andrea Iannaccone, Franco Veglio & Alberto Milan

  2. Department of Medicine-DIMED, University of Padova, Padua, Italy

    Andrea Rebellato, Marialberta Battocchio, Francesca Dassie & Francesco Fallo

Authors
  1. Eleonora Avenatti
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  2. Andrea Rebellato
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  3. Andrea Iannaccone
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  4. Marialberta Battocchio
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  5. Francesca Dassie
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  6. Franco Veglio
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  7. Alberto Milan
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  8. Francesco Fallo
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Correspondence to Alberto Milan.

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A. Milan and F. Fallo are joint last authors.

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Avenatti, E., Rebellato, A., Iannaccone, A. et al. Left ventricular geometry and 24-h blood pressure profile in Cushing’s syndrome. Endocrine 55, 547–554 (2017). https://doi.org/10.1007/s12020-016-0986-6

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