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Article: Increased myocardial fibrosis and left ventricular dysfunction in Cushing's syndrome

TitleIncreased myocardial fibrosis and left ventricular dysfunction in Cushing's syndrome
Authors
Issue Date2012
PublisherBioScientifica Ltd. The Journal's web site is located at http://www.eje-online.org/
Citation
European Journal Of Endocrinology, 2012, v. 166 n. 1, p. 27-34 How to Cite?
AbstractObjective: Active Cushing's syndrome (CS) is associated with cardiomyopathy, characterized by myocardial structural, and ultrastructural abnormalities. The extent of myocardial fibrosis in patients with CS has not been previously evaluated. Therefore, the objective of this study was to assess myocardial fibrosis in CS patients, its relationship with left ventricular (LV) hypertrophy and function, and its reversibility after surgical treatment. Design and methods: Fifteen consecutive CS patients (41 ± 12 years) were studied together with 30 hypertensive (HT) patients (matched for LV hypertrophy) and 30 healthy subjects. Echocardiography was performed in all patients including i) LV systolic function assessment by conventional measures and by speckle tracking-derived global longitudinal strain, ii) LV diastolic function assessment using E/E′, and iii) myocardial fibrosis assessment using calibrated integrated backscatter (IBS). Echocardiography was repeated after normalization of cortisol secretion (14±3 months). Results: CS patients showed the highest value of calibrated IBS (-15.1±2.5 dB) compared with HT patients (-20.0±2.6 dB, P<0.01) and controls (-23.8±2.4 dB, P<0.01), indicating increased myocardial fibrosis independent of LV hypertrophy. Moreover, calibrated IBS in CS patients was significantly related to both diastolic function (E/E′, r=0.79, P<0.01) and systolic function (global longitudinal strain, r=0.60, P=0.02). After successful surgical treatment, calibrated IBS normalized (-21.0±3.8 vs - 15.1±2.5 dB, P<0.01), suggestive of regression of myocardial fibrosis. Conclusions: Patients with CS have increased myocardial fibrosis, which is related to LV systolic and diastolic dysfunction. Successful treatment of CS normalizes the extent of myocardial fibrosis. Therefore, myocardial fibrosis appears to be an important factor in the development and potential regression of CS cardiomyopathy. © 2012 European Society of Endocrinology.
Persistent Identifierhttp://hdl.handle.net/10722/163439
ISSN
2015 Impact Factor: 3.892
2015 SCImago Journal Rankings: 1.579
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYiu, KHen_US
dc.contributor.authorMarsan, NAen_US
dc.contributor.authorDelgado, Ven_US
dc.contributor.authorBiermasz, NRen_US
dc.contributor.authorHolman, ERen_US
dc.contributor.authorSmit, JWAen_US
dc.contributor.authorFeelders, RAen_US
dc.contributor.authorBax, JJen_US
dc.contributor.authorPereira, AMen_US
dc.date.accessioned2012-09-05T05:31:22Z-
dc.date.available2012-09-05T05:31:22Z-
dc.date.issued2012en_US
dc.identifier.citationEuropean Journal Of Endocrinology, 2012, v. 166 n. 1, p. 27-34en_US
dc.identifier.issn0804-4643en_US
dc.identifier.urihttp://hdl.handle.net/10722/163439-
dc.description.abstractObjective: Active Cushing's syndrome (CS) is associated with cardiomyopathy, characterized by myocardial structural, and ultrastructural abnormalities. The extent of myocardial fibrosis in patients with CS has not been previously evaluated. Therefore, the objective of this study was to assess myocardial fibrosis in CS patients, its relationship with left ventricular (LV) hypertrophy and function, and its reversibility after surgical treatment. Design and methods: Fifteen consecutive CS patients (41 ± 12 years) were studied together with 30 hypertensive (HT) patients (matched for LV hypertrophy) and 30 healthy subjects. Echocardiography was performed in all patients including i) LV systolic function assessment by conventional measures and by speckle tracking-derived global longitudinal strain, ii) LV diastolic function assessment using E/E′, and iii) myocardial fibrosis assessment using calibrated integrated backscatter (IBS). Echocardiography was repeated after normalization of cortisol secretion (14±3 months). Results: CS patients showed the highest value of calibrated IBS (-15.1±2.5 dB) compared with HT patients (-20.0±2.6 dB, P<0.01) and controls (-23.8±2.4 dB, P<0.01), indicating increased myocardial fibrosis independent of LV hypertrophy. Moreover, calibrated IBS in CS patients was significantly related to both diastolic function (E/E′, r=0.79, P<0.01) and systolic function (global longitudinal strain, r=0.60, P=0.02). After successful surgical treatment, calibrated IBS normalized (-21.0±3.8 vs - 15.1±2.5 dB, P<0.01), suggestive of regression of myocardial fibrosis. Conclusions: Patients with CS have increased myocardial fibrosis, which is related to LV systolic and diastolic dysfunction. Successful treatment of CS normalizes the extent of myocardial fibrosis. Therefore, myocardial fibrosis appears to be an important factor in the development and potential regression of CS cardiomyopathy. © 2012 European Society of Endocrinology.en_US
dc.languageengen_US
dc.publisherBioScientifica Ltd. The Journal's web site is located at http://www.eje-online.org/en_US
dc.relation.ispartofEuropean Journal of Endocrinologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshCardiomyopathies - Etiology - Physiopathology - Surgeryen_US
dc.subject.meshCushing Syndrome - Complications - Physiopathology - Surgeryen_US
dc.subject.meshEchocardiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshFibrosis - Etiology - Physiopathology - Surgeryen_US
dc.subject.meshHumansen_US
dc.subject.meshHypertrophy, Left Ventricular - Etiology - Physiopathology - Surgeryen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshVentricular Dysfunction, Left - Etiology - Physiopathology - Surgeryen_US
dc.titleIncreased myocardial fibrosis and left ventricular dysfunction in Cushing's syndromeen_US
dc.typeArticleen_US
dc.identifier.emailYiu, KH:khkyiu@hku.hken_US
dc.identifier.authorityYiu, KH=rp01490en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1530/EJE-11-0601en_US
dc.identifier.pmid22004909-
dc.identifier.scopuseid_2-s2.0-84055199665en_US
dc.identifier.hkuros205996-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84055199665&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume166en_US
dc.identifier.issue1en_US
dc.identifier.spage27en_US
dc.identifier.epage34en_US
dc.identifier.isiWOS:000298347900005-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridYiu, KH=35172267800en_US
dc.identifier.scopusauthoridMarsan, NA=23035780700en_US
dc.identifier.scopusauthoridDelgado, V=24172709900en_US
dc.identifier.scopusauthoridBiermasz, NR=35263804800en_US
dc.identifier.scopusauthoridHolman, ER=7006388037en_US
dc.identifier.scopusauthoridSmit, JWA=24577861400en_US
dc.identifier.scopusauthoridFeelders, RA=6602151311en_US
dc.identifier.scopusauthoridBax, JJ=35379683700en_US
dc.identifier.scopusauthoridPereira, AM=7402230059en_US

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