title: Left ventricular geometry and 24-h blood pressure profile in Cushing's syndrome.
abstract: Cushing's syndrome (CS) is associated with cardiovascular disease. The impact of the hemodynamic load on left ventricular mass (LVM) in patients with CS is not well known. In fact, the effects of 24-h blood pressure (BP) load and BP circadian rhythm on cardiac structure and function have not been studied. Aim of the present study has thus been to assess the presence of cardiac remodeling in patients with newly diagnosed CS, combining evaluation of cardiac remodeling and assessment of BP burden derived by 24-h ambulatory blood pressure monitoring (ABPM). 25 patients (4 M, 21 F) with CS underwent echocardiography in order to assess cardiac morphology and geometry (relative wall thickness-RWT). As controls, 25 subjects similar for demographic characteristics and 24-h BP were used. CS Patients were similar to controls by age, sex, mean 24-h BP, and body mass index. There was a significant increase in left ventricular mass (LVM; 44.4 ± 14.7 vs. 36.9 ± 10 g/m2.7, p = 0.03) and a significant increase in RWT (0.46 ± 0.07 vs. 0.41 ± 0.08, p = 0.02) in CS patients compared to controls. The prevalence of CS patients with pressure non-dipping profile was greater than that of controls (56 vs. 16 %, p < 0.05), with no significant association with LVM or geometry. 24-h urinary cortisol was not associated with LVM (r = 0.1, p = 0.5) or RWT (r = 0.02, p = 0.89) in the CS group. In conclusion, LVM and the concentric pattern of the left ventricle are relatively independent from 24-h BP load and profile (dipping/non-dipping) in CS patients.
authors.affiliation: Internal Medicine and Hypertension Division, Department of Medical Sciences, University Hospital AOU Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Avenatti
authors.affiliation: Department of Medicine-DIMED, University of Padova, Padua, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rebellato
authors.affiliation: Internal Medicine and Hypertension Division, Department of Medical Sciences, University Hospital AOU Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Iannaccone
authors.affiliation: Department of Medicine-DIMED, University of Padova, Padua, Italy.
authors.forename: Marialberta
authors.initials: M
authors.lastname: Battocchio
authors.affiliation: Department of Medicine-DIMED, University of Padova, Padua, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Dassie
authors.affiliation: Internal Medicine and Hypertension Division, Department of Medical Sciences, University Hospital AOU Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
authors.affiliation: Internal Medicine and Hypertension Division, Department of Medical Sciences, University Hospital AOU Città della Salute e della Scienza di Torino, University of Torino, Via Genova 3, 10126, Turin, Italy. alberto.milan@gmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Milan
authors.affiliation: Department of Medicine-DIMED, University of Padova, Padua, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fallo
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003480:Cushing Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D020257:Ventricular Remodeling / Q000502:physiology*
keywords: Ambulatory blood pressure/home blood pressure monitor; Cardiac remodeling; Cushing’s syndrome; Dipping profile; Secondary high blood pressure