Cardiovascular Function May Improve After Cure of Cushing Syndrome

Cardiovascular function, quality of life (QoL), and physical and mental health may improve over time when Cushing syndrome (CS) is cured, according to an abstract presented at ENDO 2018: The Endocrine Society Annual Meeting, held March 17-20 in Chicago, Illinois.

Because CS is associated with increased cardiovascular morbidity, researchers in Germany investigated cardiovascular function, QoL, and mental/physical health in 17 patients with overt and cured CS.

They found that from initial diagnosis to at least 6 months after surgical care there was a significant decrease in body mass index (P <.005) and waist-to-hip ratio (P <.05), as well as a trend towards decreased low-density lipoprotein (LDL) cholesterol and glycated hemoglobin (HBA1c) levels.

Significantly less systolic dysfunction was detected on echocardiography (P <.05), whereas measurements of diastolic dysfunction and left ventricular mass remained unchanged. In addition, significantly lower hypertensive blood pressure levels (P <.05) and a tendency toward less non-dipper profiles were observed.

This improvement in blood pressure was also observed by fewer patients requiring treatment with antihypertensive medications from initial diagnosis to surgical care (median number of drugs, 10 vs 6, respectively; P <.05). However, no relevant electrocardiogram pathologies and only moderate changes in endothelial dysfunction were detected.

Most patients reported significant improvements in QoL, mental/physical health, anxiety, and depression, but formally cured patients reported a worsening of their anxiety and depression.  

“This prospective [surgical care] study suggests that uncontrolled hypertension, systolic/diastolic dysfunction, left ventricular hypertrophy, and endothelial impairment may be at least partially reversible when CS is cured. QoL as well as physical and mental health improve over time, whereas anxiety and depression may even worsen (at least short-term) in some patients. Sustainability of these results will be examined by an extended surgical care [study] in a larger cohort,” concluded the researchers.

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Reference

Ehlich K, Mueller M, Nordbeck P, et al. Cardiovascular functional status during overt and after cure of endogenous Cushing‘s syndrome: first results from a prospective longitudinal study. Presented at: ENDO 2018: The Endocrine Society Annual Meeting; Chicago, IL; March 17-20, 2018. Abstract SUN-016.