Analysis of novel ventricular repolarization parameters in Cushing

Caglar Keskin; Cağrı Yayla; Ekin Yiğit Koroğlu; Muhammed Sacıkara; Didem Ozdemir; Oya Topaloglu; Reyhan Ersoy; Bekir Cakir

doi:10.1530/endoabs.110.P92

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Endocrine Abstracts (2025) 110 P92 | DOI: 10.1530/endoabs.110.P92

ECEESPE2025 Poster Presentations Adrenal and Cardiovascular Endocrinology (169 abstracts)

Analysis of novel ventricular repolarization parameters in Cushing’s syndrome: A comparative study

Caglar Keskin ¹ , Çağrı Yayla ² , Ekin Yiğit Köroğlu ¹ , Muhammed Saçıkara ¹ , Didem Ozdemir ³ , Oya Topaloglu ³ , Reyhan Ersoy ³ & Bekir Cakir ³

Author affiliations

¹Ankara Bilkent City Hospital, Department of Endocrinology and Metabolism, ankara, Türkiye; ²Ankara Bilkent City Hospital University of Health Sciences, Department of Cardiology, Ankara, Türkiye; ³Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Endocrinology and Metabolism, ankara, Türkiye

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Introduction: Cardiovascular complications are leading causes of morbidity and mortality in Cushing’s disease, including hypertension, myocardial infarction, stroke, dilated-hypertrophic cardiomyopathy, heart failure, pulmonary embolism, and arrhythmias. Electrocardiography (ECG) remains one of the most reliable methods for assessing cardiac electrical activity. The Tpeak-end (Tp-e) interval, which represents the time from the peak of the T wave to its end, is a repolarization parameter that reflects both global and transmural repolarization. An increased Tpe interval has been shown to predict in-hospital and long-term mortality in patients with acute myocardial infarction. These ECG parameters have been associated with poor prognosis and mortality in various diseases beyond cardiovascular conditions. This study aimed to evaluate changes in ventricular repolarization parameters on ECG in patients with Cushing’s syndrome.

Methods: This study included 45 patients with ACTH-dependent or ACTH-independent Cushing’s disease, along with a control group matched for age and gender. Patients with known cardiovascular diseases, those using antiarrhythmic drugs, and those with electrolyte disturbances were excluded. All participants underwent a standard 12-lead ECG (filter 40 Hz, 25 mm/s, 10 mm/mV). An experienced cardiologist measured heart rate, P-wave duration, QRS complex, T-wave duration, PR interval, Tp-e interval, and QT interval.

Results: A total of 83 participants were included, comprising 41 patients with Cushing’s syndrome (Female/Male: 32/9) and 42 healthy controls. Among the patients, 27 had ACTH-independent and 14 had ACTH-dependent Cushing’s disease. P-wave duration, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were significantly increased in the Cushing’s group compared to controls (P<0.001). Additionally, the QTc interval and P-wave duration showed a significant negative correlation with midnight salivary cortisol levels.

Conclusion: Our study found that P-wave duration, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were elevated in patients with Cushing’s syndrome compared to control subjects. These findings suggest that ECG changes linked to ventricular arrhythmias and mortality may be present in Cushing’s syndrome, highlighting the need for further investigation and monitoring of these patients.