title: Normalization of catecholamine production following resection of phaeochromocytoma positively influences carotid vascular remodelling.
abstract: OBJECTIVE
  To evaluate the influence of plasma catecholamines on the vascular structure in humans, the effects of catecholamine normalization on the carotid wall of patients with phaeochromocytoma (PHEO) were investigated. A prospective study in patients with PHEO before and after (first follow-up: 20.5+/-1.8 months, second follow-up: 31.5+/-2.2 months) successful surgery was conducted in the University Referral Center for Blood Pressure Diseases. Ten consecutive patients with PHEOs and ten age- and blood pressure-matched controls were investigated. Intima-media thickness (IMT) by two-dimensional conventional ultrasonography and corrected ultrasonic integrated backscatter signal (C-IBS) analysis of carotid arteries were investigated in basal conditions and after mass removal.
  
  
  RESULTS
  In PHEOs, at variance with the expected reduction in metanephrines and catecholamines, no variation in body weight, blood pressure and lipid profile was observed after operation. IMT and C-IBS values in patients with PHEO were greater (at least P<0.01) than in controls. At long-term follow-up after surgery, a significant reduction in mean carotid IMT (P<0.0009) and C-IBS (P<0.009) values was observed. A significant correlation (r=0.54, P<0.03) was found between absolute reduction in C-IBS values and absolute decrement in urinary normetanephrine levels.
  
  
  CONCLUSIONS
  Our study shows that normalization of catecholamine levels after the removal of PHEO improves carotid IMT and reduces carotid wall fibrosis even without influencing blood pressure and lipid profile. These findings confirm that high catecholamine tone in humans directly influences vascular remodelling of carotid arteries.
authors.affiliation: Department of Internal Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy. g.bernini@med.unipi.it
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Bernini
authors.forename: Fabio
authors.initials: F
authors.lastname: Galetta
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Franzoni
authors.forename: Michele
authors.initials: M
authors.lastname: Bardini
authors.forename: Chiara
authors.initials: C
authors.lastname: Taurino
authors.forename: Angelica
authors.initials: A
authors.lastname: Moretti
authors.forename: Matteo
authors.initials: M
authors.lastname: Bernini
authors.forename: Piero
authors.initials: P
authors.lastname: Berti
authors.forename: Paolo
authors.initials: P
authors.lastname: Miccoli
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvetti
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000097:blood / Q000473:pathology*; D016022:Case-Control Studies; D002395:Catecholamines / Q000097:blood* / Q000378:metabolism; D005260:Female; D005355:Fibrosis / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000097:blood; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014463:Ultrasonography
chemical_list: D002395:Catecholamines