[Chronic pheochromocytoma-induced myocardial injuries: What should we expect from modern and classical echocardiographic tools?]

Autor: Boulestreau R; Centre d'excellence en hypertension artérielle, CHU de Bordeaux, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France. Electronic address: rboulestreau@gmail.com., Jambon F; Service de néphrologie et transplantation rénale, CHU de Bordeaux, hôpital Pellegrin, rue de la Pelouse-de-Douet, 33000 Bordeaux, France., Cremer A; Centre d'excellence en hypertension artérielle, CHU de Bordeaux, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France., Doublet J; Centre d'excellence en hypertension artérielle, CHU de Bordeaux, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France., Nunes ML; Service d'endocrinologie, CHU de Bordeaux, hôpital Haut-Leveque, avenue du Haut-Leveque, 33600 Pessac, France., Ferrière A; Service d'endocrinologie, CHU de Bordeaux, hôpital Haut-Leveque, avenue du Haut-Leveque, 33600 Pessac, France., Tabarin A; Service d'endocrinologie, CHU de Bordeaux, hôpital Haut-Leveque, avenue du Haut-Leveque, 33600 Pessac, France., Haissaguerre M; Service d'endocrinologie, CHU de Bordeaux, hôpital Haut-Leveque, avenue du Haut-Leveque, 33600 Pessac, France., Gosse P; Centre d'excellence en hypertension artérielle, CHU de Bordeaux, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France.
Jazyk: francouzština
Zdroj: Annales de cardiologie et d'angeiologie [Ann Cardiol Angeiol (Paris)] 2020 Nov; Vol. 69 (5), pp. 241-246. Date of Electronic Publication: 2020 Sep 23.
DOI: 10.1016/j.ancard.2020.09.010
Abstrakt: Introduction: Pheochromocytoma is a rare disease, which may manifest as severe cardiac complications. Apart from these situations, the "chronic" cardiac impact is not clearly defined. A cardiac MRI study suggests that these patients are carrying areas of fibrosis and foci of left ventricular myocarditis. Since these abnormalities are usually associated with altered left ventricular longitudinal systolic strain, we hypothesize that this strain is altered in patients with a "chronic" pheochromocytoma.
Method: This retrospective case-control study was performed using patients from the Bordeaux University Hospital database, included between 2008 and 2016. We compared the left ventricular global longitudinal strain (GLS), radial and circumferential systolic strain and classic echocardiographic parameters between patients with pheochromocytoma and controls matched for age, sex, body mass index and systolic blood pressure.
Results: The analysis included 47 patients and 47 correctly matched controls. There were no statistically significant differences between the 2 groups in terms of GLS (-20.7±2.4% vs. -20.2±2.7%, P=0.40), radial strain, left ventricular mass or diastolic function. Left ventricular ejection fraction and circumferential strain were significantly higher in patients than in controls, with a significantly lower telediastolic diameter.
Conclusion: No significant changes in GLS were observed in our pheochromocytoma patients, compared with controls. Several hypotheses may explain these results. The presence of fibrosis foci and areas of left ventricular myocarditis being associated with a poor cardiological prognosis, a systematic cardiac MRI could be discussed in these patients, until further studies are performed.
(Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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