Blood Pressure Profile, Catecholamine Phenotype, and Target Organ Damage in Pheochromocytoma/Paraganglioma
Autor: | Jiří Widimský, Ján Rosa, Ondřej Petrák, Zuzana Krátká, Petr Waldauf, Robert Holaj, David Michalský, Květoslav Novák, Branislav Štrauch, Alice Markvartová, Judita Klímová, Jan Kvasnička, Barbora Hamplová, Tomáš Zelinka |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male Pathology medicine.medical_specialty Ambulatory blood pressure genetic structures Physiology Endocrinology Diabetes and Metabolism Clinical Biochemistry Adrenal Gland Neoplasms Context (language use) Blood Pressure Pheochromocytoma Biochemistry CONSECUTIVE SAMPLE Paraganglioma chemistry.chemical_compound Endocrinology Catecholamines Diabetes mellitus Internal medicine Internal Medicine medicine Humans Pulse wave velocity Metanephrine Retrospective Studies business.industry Biochemistry (medical) Blood Pressure Determination Middle Aged medicine.disease Target organ damage Phenotype Blood pressure chemistry Catecholamine Female Cardiology and Cardiovascular Medicine business medicine.drug |
Zdroj: | The Journal of clinical endocrinology and metabolism. 104(11) |
ISSN: | 1945-7197 |
Popis: | Context Impaired diurnal blood pressure (BP) variability is related to higher cardiovascular risk. Objective To assess diurnal variability of BP and its relation to target organ damage (TOD) and catecholamine phenotype in a consecutive sample of pheochromocytoma/paraganglioma (PPGL). Design We included 179 patients with PPGL All patients underwent 24 hours of ambulatory BP monitoring to determine dipping status. Differences in plasma metanephrine or urine adrenaline were used to distinguish catecholamine biochemical phenotype. To evaluate TOD, renal functions, presence of left ventricle hypertrophy (LVH), and the subgroup (n = 111) carotid-femoral pulse wave velocity (PWV) were assessed. Structural equation modeling was used to find the relationship among nocturnal dipping, catecholamine phenotype, and TOD parameters. Results According to the nocturnal dipping, patients were divided into the three groups: dippers (28%), nondippers (40%), and reverse dippers (32%). Reverse dippers were older (P < 0.05), with a higher proportion of noradrenergic (NA) phenotype (P < 0.05), a higher prevalence of diabetes mellitus (P < 0.05), and sustained arterial hypertension (P < 0.01) and its duration (P < 0.05), as opposed to the other groups. All parameters of TOD were more pronounced only in reverse dippers compared with nondippers and dippers. The presence of NA phenotype (=absence of adrenaline production) was associated with reverse dipping and TOD (LVH and PWV). Conclusions Patients with reverse dipping had more substantial TOD compared with other groups. The NA phenotype plays an important role, not only in impaired diurnal BP variability but also independently from dipping status in more pronounced TOD of heart and vessels. |
Databáze: | OpenAIRE |
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