Hypertrophic remodeling of subcutaneous small resistance arteries in patients with Cushing's syndrome.
OBJECTIVE
Structural alterations of small resistance arteries in essential hypertensive patients (EH) are mostly characterized by inward eutrophic remodeling. However, we observed hypertrophic remodeling in patients with renovascular hypertension, in those with acromegaly, as well as in patients with non-insulin-dependent diabetes mellitus, suggesting a relevant effect of humoral growth factors on vascular structure, even independent from the hemodynamic load. Cortisol may stimulate the renin-angiotensin system and may induce cardiac hypertrophy. However, presently no data are available about small artery structure in patients with Cushing's syndrome.


METHODS
We have investigated the structure of sc small resistance arteries in 12 normotensive subjects (NT), in 12 EH subjects, and in eight patients with Cushing's syndrome (CS). Small arteries from sc fat were dissected and mounted on a micromyograph. The normalized internal diameter, media thickness, media to lumen ratio, and the media cross-sectional area were measured, as well as indices of oxidative stress.


RESULTS
Demographic variables were similar in the three groups, except for clinic blood pressure. The media to lumen ratio was significantly greater in EH and CS, compared with NT; no difference was observed between EH and CS. The media cross-sectional area was significantly greater in CS compared with EH and with NT. An increased vascular oxidative stress was present in CS, as demonstrated by increased levels of superoxide anions, cyclooxygenase-1 and endothelial nitric oxide synthase in the microvessels.


CONCLUSIONS
Our results suggest the presence of hypertrophic remodeling in sc small resistance arteries of CS, probably as a consequence of growth-promoting properties of circulating cortisol and/or increased vascular oxidative stress.
Department of Medical and Surgical Sciences, University of Brescia, c/o 2 Medicina, Spedali Civili, 25100 Brescia, Italy. rizzoni@med.unibs.it
Damiano
D
Rizzoni
Enzo
E
Porteri
Carolina
C
De Ciuceis
Luigi F
LF
Rodella
Silvia
S
Paiardi
Nicola
N
Rizzardi
Caterina
C
Platto
Gianluca E M
GE
Boari
Annamaria
A
Pilu
Guido A M
GA
Tiberio
Stefano M
SM
Giulini
Gaia
G
Favero
Rita
R
Rezzani
Claudia Agabiti
CA
Rosei
Giuseppe
G
Bulgari
Daniele
D
Avanzi
Enrico Agabiti
EA
Rosei
D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D001158:Arteries / Q000473:pathology*; D003480:Cushing Syndrome / Q000473:pathology*; D051545:Cyclooxygenase 1 / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009213:Myography; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D018384:Oxidative Stress / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D012867:Skin / Q000098:blood supply* / Q000473:pathology*; D013481:Superoxides / Q000378:metabolism; D014655:Vascular Resistance / Q000502:physiology
D013481:Superoxides; D052250:Nitric Oxide Synthase Type III; D051545:Cyclooxygenase 1