Objective: To verify whether tissue Doppler imaging (TDI) could contribute to a better understanding of the natural history of cardiomyopathy in active Cushings disease (CD), through its enhanced sensitivity to diastolic dysfunction, and identifying preliminary regional signs of systolic dysfunction, before the appearance of clinical symptoms of cardiac pathologies.
Methods: Eleven women with newly diagnosed CD, and 15 control cases, purposely matched for gender, age, body mass index and co-incidental diseases were enrolled in this study. Conventional echocardiography and TDI examinations were performed with Vingmed System 7 (Vivid 7 Pro; Horten, Norway) using a 2.5-to 3.5-Mz transducer, and carried out by a single experienced cardiologist. The peak systolic velocity (Sm), early diastolic myocardial peak velocity (Em), late diastolic myocardial peak velocity (Am), isovolumic acceleration (IVA), myocardial pre-contraction time (PCTm), myocardial contraction time (CTm) and myocardial relaxation time (RTm) were measured at septal (S) and lateral (L) mitral anulus.
Results: In TDI, EmL, EmS, EmL/AmL ratio, and EmS/AmS ratio were significantly lower (P<0.05), and PCTmL/CTmL ratio and PCTmS/CTmS ratio were higher (P<0.05), SmL, SmS, AmL, AmS, PCTmL, PCTmS, CTmL, IVRTmL and IVRTmS values were similar in patients with CD than controls (P>0.05). Lateral and septal annulus IVA were significantly lower in patients with CD than the control group (P<0.05). Correlation analysis showed that IVA-L correlated positively with SmL (r=0.58; P=0.002) and IVA-S correlated positively with SmS (r=0.51; P=0.008).
Conclusion: The present study is the first study evaluating left ventricular functions in patients with active CD by TDI. We recommend using TDI, in addition to conventional echocardiography parameters for the cardiovascular risk assessment of patients with Cushing syndrome.