Endocrine Abstracts (2008) 16 P32

Assessment of left ventricular functions by tissue Doppler echocardiography in patients with Cushing's disease

Nihal Akar Bayram1, Reyhan Ersoy2, Cevdet Aydin2, Kamile Gul2, Telat Keles1, Oya Topaloglu2, Tahir Durmaz1, Engin Bozkurt1 & Bekir Cakir2


1Department of Cardiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey; 2Department of Endocrinology and Metabolism, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.


Objective: To verify whether tissue Doppler imaging (TDI) could contribute to a better understanding of the natural history of cardiomyopathy in active Cushing’s 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 (S’m), early diastolic myocardial peak velocity (E’m), late diastolic myocardial peak velocity (A’m), isovolumic acceleration (IVA), myocardial pre-contraction time (PCT’m), myocardial contraction time (CT’m) and myocardial relaxation time (RT’m) were measured at septal (S) and lateral (L) mitral anulus.

Results: In TDI, E’mL, E’mS, E’mL/A’mL ratio, and E’mS/A’mS ratio were significantly lower (P<0.05), and PCT’mL/CT’mL ratio and PCT’mS/CT’mS ratio were higher (P<0.05), S’mL, S’mS, A’mL, A’mS, PCT’mL, PCT’mS, CT’mL, IVRT’mL and IVRT’mS 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 S’mL (r=0.58; P=0.002) and IVA-S correlated positively with S’mS (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.

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