The relationship between aortic stiffness and left ventricular function in patients with Cushings disease
Nihal Akar Bayram1, Reyhan Ersoy2, Didem Ozdemir Sen2, Serap Soytac Inancli2, Tahir Durmaz1, Telat Keles1, Engin Bozkurt1 & Bekir Cakir2
Introduction: Aortic elastic properties and aortic stiffness are important determinants of increased cardiovascular morbidity and mortality in different diseases. We aimed to investigate the aortic function and to evaluate the relationship between aortic stiffness and systolic and diastolic functions of the left ventricle in patients with Cushings disease (CD).
Material and method: Fourteen women and one man with newly diagnosed CD, and 17 control cases were enrolled in this study. All subjects underwent echocardiography and systolic and diastolic aortic measurements were noted from M-mode aortic root. Aortic elastic parameters, aortic strain, and distensibility were calculated. Left ventricle functions were measured using echocardiography including, two dimensional, M-mode, conventional Doppler, and tissue Doppler imaging.
Results: Aortic strain (7.4±1.9 vs 12.3±2.4%; P<0.001), and aortic distensibility (3.2±1.1 10−6 cm2/dyn versus 5.6±1.4 10−6 cm2/dyn; P<0.001) were significantly decreased in patient group compared with control group. Mitral E velocity and the ratio of E/A were significantly lower and deceleration time of E was significantly prolonged in patients with CD. We also observed that patients with CD had markedly lower early diastolic myocardial peak velocity (Em) and Em/Am ratio and higher Tei index than in control group. Aortic elastic parameters are deranged in patients with CD and there is a significant correlation between left ventricular parameters determined by tissue Doppler echocardiography and aortic elastic parameters in these patients.
Conclusion: Patients with CD should be screened with routine physical examination (including anthropometric measures and blood pressure measurement) and laboratory tests (including blood chemistry and electrocardiogram) as well as oral glucose tolerance test, 24 h ambulatory blood pressure monitoring, echocardiography and carotid artery ultrasonography. In addition to these investigations, we suggest evaluation of aortic stiffness which is an early marker for atherosclerosis in patients with CS.