Increased arterial rigidity in children affected by Cushing's syndrome after successful surgical cure.
BACKGROUND
Complications, such as secondary hypertension, probably related to the loss of arterial elasticity, frequently arise in Cushing's syndrome, and may persist even beyond cure. This study aimed at demonstrating that arterial compliance, evaluated by automated recording of the QKd interval, was lower in children after a successful surgery for Cushing's syndrome than in a control group of healthy subjects.


METHODS
In all, 23 young girls aged between 11 and 18 years who had undergone a surgical cure for Cushing syndrome - 18 with a pituitary adenoma, three with a primary adrenal disease, and two suffering from ectopic adrenocorticotrope hormone secretion - were enrolled. Arterial stiffness was measured by the standardised non-invasive QKd 100-60 method. A 24-hour ambulatory blood pressure monitoring and a transthoracic echocardiography were also performed.


RESULTS
The children operated for Cushing's syndrome showed disadvantageous differences in 24-hour ambulatory blood pressure monitoring and in QKD 100-60 value, with p less than 0.01, compared with the control group.


CONCLUSIONS
In spite of its successful surgical cure, Cushing's syndrome results in a significantly decreased arterial distensibility when compared with the control group, which might explain these differences in blood pressure levels. It underlines a significantly higher cardiovascular risk, notwithstanding both the normalisation of cortisol secretion and the very early age of the patients.
Bassareo
Pier Paolo
PP
Department of Cardiovascular and Neurological Sciences, University of Cagliari, Italy. piercard@inwind.it
Marras
Andrea Raffaele
AR
Pasqualucci
Daniele
D
Mercuro
Giuseppe
G
D000293:Adolescent; D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D003480:Cushing Syndrome / Q000503:physiopathology* / Q000601:surgery / Q000652:urine; D004452:Echocardiography; D004548:Elasticity; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000097:blood
D006854:Hydrocortisone