Cardiac magnetic resonance reveals biventricular impairment in Cushing’s syndrome: a multicentre case-control study

Purpose Cushing’s syndrome (CS) is associated with severe cardiovascular (CV) morbidity and mortality. Cardiac magnetic resonance (CMR) is the non-invasive gold standard for assessing cardiac structure and function; however, few CMR studies explore cardiac remodeling in patients exposed to chronic g...

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Bibliographic Details
Published in:Endocrine 2024, Vol.85 (2), p.937-946
Main Authors: Feola, Tiziana, Cozzolino, Alessia, De Alcubierre, Dario, Pofi, Riccardo, Galea, Nicola, Catalano, Carlo, Simeoli, Chiara, Di Paola, Nicola, Campolo, Federica, Pivonello, Rosario, Isidori, Andrea M., Giannetta, Elisa
Format: Article
Language:English
Subjects:
Adrenal Gland Neoplasms - complications
Adrenal Gland Neoplasms - diagnostic imaging
Adrenocorticotropic hormone
Adult
Aged
Blood levels
Blood pressure
Cardiovascular diseases
Cardiovascular system
Case-Control Studies
Chronic exposure
Cushing Syndrome - complications
Cushing Syndrome - diagnostic imaging
Diabetes
Endocrinology
Female
Heart
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Humanities and Social Sciences
Humans
Internal Medicine
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
multidisciplinary
Nervous system diseases
Original Paper
Pituitary
Prospective Studies
Remission
Risk factors
Science
Structure-function relationships
Ventricle
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Summary:Purpose Cushing’s syndrome (CS) is associated with severe cardiovascular (CV) morbidity and mortality. Cardiac magnetic resonance (CMR) is the non-invasive gold standard for assessing cardiac structure and function; however, few CMR studies explore cardiac remodeling in patients exposed to chronic glucocorticoid (GC) excess. We aimed to describe the CMR features directly attributable to previous GC exposure in patients with cured or treated endogenous CS. Methods This was a prospective, multicentre, case-control study enrolling consecutive patients with cured or treated CS and patients harboring non-functioning adrenal incidentalomas (NFAI), comparable in terms of sex, age, CV risk factors, and BMI. All patients were in stable condition and had a minimum 24-month follow-up. Results Sixteen patients with CS and 15 NFAI were enrolled. Indexed left ventricle (LV) end-systolic volume and LV mass were higher in patients with CS ( p  =  0.027; p  =  0.013 ); similarly, indexed right ventricle (RV) end-diastolic and end-systolic volumes were higher in patients with CS compared to NFAI ( p  =  0.035; p  =  0.006 ). Morphological alterations also affected cardiac function, as LV and RV ejection fractions decreased in patients with CS ( p  =  0.056; p  =  0.044 ). CMR features were independent of metabolic status or other CV risk factors, with fasting glucose significantly lower in CS remission than NFAI ( p  
ISSN:1559-0100
1355-008X
1559-0100
DOI:10.1007/s12020-024-03856-7