Endocrine Abstracts (2011) 26 P22

Cardiac structure and function in patients with adrenal incidentaloma with and without subclinical Cushing's syndrome

M De Leo1, M Galderisi2, A Cozzolino1, C Simeoli1, P Vitale1, R Raia2, A Colao1 & R Pivonello1

1Department of Molecular and Clinical Endocrinology and Oncology, ‘Federico II’ University, Naples, Campania, Italy; 2Department of Internal Medicine, ‘Federico II’ University, Naples, Campania, Italy.

Hypercortisolism has been reported to affect cardiac structure and performance. Subclinical Cushing’s syndrome (SCS) is increasingly being reported in incidentally discovered adrenal tumors; its hallmark is a mild autonomous cortisol hypersecretion without specific clinical syndrome of glucocorticoid excess. The aim of this study was to compare cardiac structure and function in patients with adrenal incidentaloma. Thirty patients (10 men, 15 women, 32–74 years) and 30 sex- and age-matched healthy controls entered the study: among patients, 11 had SCS and the remaining 14 had normal cortisol secretion. All patients and controls were submitted to Doppler echocardiography, with evaluation of left ventricular (LV) mass index (LVMi), ejection fraction (EF), main parameter of systolic function, and early (E) to late or atrial (A) peak velocity (E/A), main parameter of diastolic function, together with the measurement of systolic (SBP) and diastolic (DBP) blood pressure. SBP (P<0.01) but not DBP, was higher in patients than in controls. At Doppler echocardiography, EF and E/A were significantly reduced in patients compared to controls. However, no significant difference was found in LVMi. In particular, both patients with and without SCS had reduced EF and E/A compared to controls. A slight but not significant increase in LVMi was found in patients with but not in patients without SCS. No significant difference in SBP and DBP, and only slight difference in cardiac parameters, were found between patients with and without SCS. In conclusion, patients with adrenal incidentaloma have a mild impairment of cardiac performance, represented by both a systolic and diastolic dysfunction independently on the presence of SCS. These findings suggest that patients with incidentally discovered, or clinically non-functioning adrenal tumors need to be monitored for cardiac performance during their follow-up.

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