Echocardiographic alterations in patients with non-functioning adrenal incidentaloma.
OBJECTIVE
While left ventricular (LV) dysfunction has been described in patients with Cushing's syndrome (CS), data concerning morphologic and functional cardiac alterations in patients with incidentally discovered adrenal masses [adrenal "incidentaloma" (AI)], without overt hypercortisolism, are lacking. In this study the echocardiographic characteristics of patients with AI were evaluated and then compared with those of lean and obese normotensive subjects.


METHODS
Twenty-one patients with AI, without clinical or subclinical hypercortisolism, 18 normotensive obese subjects matched for gender and body mass index (BMI) and 20 normotensive lean subjects were studied. Echocardiography was performed in all subjects. In all patients plasma ACTH, serum cortisol, and DHEA-S levels were measured.


RESULTS
Patients with AI showed greater impairment of several echocardiographic indices of LV hypertrophy and diastolic dysfunction compared to normotensive lean subjects (p<0.05), but did not differ from those in obese subjects. Hypertensive AI patients showed a greater alteration of echocardiographic parameters (p<0.05) and higher BMI (p<0.01) and cortisol values (p<0.05) than normotensive ones. Plasma ACTH and serum cortisol were similar in AI patients and in obese controls, while DHEA-S levels were lower in AI (p<0.05). No correlations between cortisol secretion and echocardiographic parameters were found.


CONCLUSIONS
In patients with non-functioning AI there is an impairment of cardiac morphology and function. These data suggest that patients with AI should be carefully screened also by means of echocardiographic studies.
Ermetici
F
F
Endocrinology Unit, Department of Medical and Surgical Sciences, IRCCS Policlinico San Donato, University of Milan, 20097 San Donato Milanese, Italy.
Dall'Asta
C
C
Malavazos
A E
AE
Coman
C
C
Morricone
L
L
Montericcio
V
V
Ambrosi
B
B
D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D003480:Cushing Syndrome / Q000000981:diagnostic imaging / Q000473:pathology; D004452:Echocardiography / Q000639:trends; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000473:pathology