Normalization of catecholamine production following resection of phaeochromocytoma positively influences carotid vascular remodelling.
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.
Bernini
Giampaolo
G
Department of Internal Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy. g.bernini@med.unipi.it
Galetta
Fabio
F
Franzoni
Ferdinando
F
Bardini
Michele
M
Taurino
Chiara
C
Moretti
Angelica
A
Bernini
Matteo
M
Berti
Piero
P
Miccoli
Paolo
P
Salvetti
Antonio
A
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
D002395:Catecholamines