AI Article Synopsis

  • Patients with primary aldosteronism (PA) accompanied by autonomous cortisol co-secretion (ACS) show worse cardiac outcomes and left ventricular hypertrophy compared to those without ACS.
  • A study of 367 PA patients indicated that those with ACS had higher NTpro-BNP levels, which correlate with cortisol levels, signifying more cardiac stress initially and less recovery post-treatment.
  • Over time, only patients without ACS showed significant improvements in heart dimensions and mass, emphasizing the long-term impact of ASC on cardiac health in PA patients.

Article Abstract

Context: Patients with primary aldosteronism (PA) have higher cardiac comorbidities including more pronounced left ventricular hypertrophy than patients with essential hypertension.

Objective: Autonomous cortisol cosecretion (ACS) is a common subtype in PA associated with a worse metabolic profile.

Hypothesis: Autonomous cortisol cosecretion may affect myocardial parameters and result in a worse cardiac outcome compared to patients with PA and without ACS.

Methods: Three hundred and sixty-seven patients with PA undergoing 1 mg dexamethasone suppression test (DST) and echocardiography at baseline from 2 centers of the German Conn's Registry were included. Follow-up for up to 3.8 years was available in 192 patients.

Results: Patients with PA and ACS had higher NT-proBNP levels at baseline compared to patients with PA without ACS (114 vs 75.6 pg/mL, P = .02), but showed no difference in echocardiography values. NT-proBNP levels showed a significant positive correlation (r = 0.141, P = .011) with cortisol levels after DST at baseline. In response to therapy of PA, NT-proBNP levels decreased, but remained significantly higher in patients with ACS compared to patients without ACS. At follow-up, left ventricle end-diastolic dimension (LVEDD) decreased significantly only in patients without ACS. Left atrial diameter (LAD) decreased significantly in patients without ACS and in female patients with ACS but not in male patients. Left ventricular mass index (LVMI) significantly improved in female patients without ACS but remained unchanged in female patients with ACS as well as in male patients at follow-up.

Conclusions: In patients with PA, concomitant ACS is associated with a worse cardiac profile and only partial recovery even years after initiation of targeted PA therapy.

Download full-text PDF

Source
http://dx.doi.org/10.1093/ejendo/lvae119DOI Listing

Publication Analysis

Top Keywords

patients acs
36
patients
17
nt-probnp levels
16
autonomous cortisol
12
cortisol cosecretion
12
compared patients
12
female patients
12
acs
11
patients primary
8
left ventricular
8

Similar Publications

Introduction: Acute myocardial infarction (AMI) poses a significant global health burden, warranting meticulous management strategies, particularly in patients with concurrent anemia. Blood transfusion strategies play a pivotal role in optimizing oxygen delivery while minimizing transfusion-related risks. Two contrasting approaches, liberal and restrictive transfusion strategies, have emerged, yet their comparative effectiveness remains uncertain due to conflicting evidence.

View Article and Find Full Text PDF

Background: The COVID-19 lockdown had profound effects on society and healthcare. Cardiology departments reported declines in chest pain evaluations and acute coronary syndrome (ACS) diagnoses. However, the pattern of chest pain in primary care is not clear yet.

View Article and Find Full Text PDF

Background: Gastrointestinal perforation (GIP) is a life-threatening condition that necessitates immediate surgical intervention. This study aims to identify prognostic factors in patients with GIP treated within a standardized acute care surgery (ACS) framework.

Materials And Methods: This single center retrospective cohort study analyzed patients diagnosed with GIP who underwent emergent surgery and were admitted to the intensive care unit between January 2013 and March 2023.

View Article and Find Full Text PDF

Background: Multiple management guidelines for intraductal papillary mucinous neoplasms (IPMNs) have been published to improve risk stratification and resource utilization. This study aims to evaluate trends in endoscopic ultrasound (EUS) use and agreement between cross-sectional imaging and EUS for specific pancreas cystic lesion (PCL) features.

Methods: This retrospective cohort study included consecutive adults undergoing EUS for suspected IPMN detected with cross-sectional imaging (CT/MRCP) between 2013 and 2015 (Cohort 1) and 2018-2020 (Cohort 2).

View Article and Find Full Text PDF

Background: Differences in bone metabolism between patients with adrenal Cushing's syndrome (ACS) and Cushing's disease (CD) have been noted, but the impact of steroid hormones on bone metabolism remains underexplored. The purpose of this study is to explore the differences in bone metabolism between the two subtypes of Cushing's syndrome and the correlation between hormones synthesized by the adrenal reticulum and bone metabolism.

Method: This retrospective study included 75 premenopausal women, consisting of 33 patients with CD and 42 patients with ACS.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!