Cardiovascular status in endogenous cortisol excess: the prospective CV-CORT-EX study
Authors' conclusion
In patients with overt CS, cured CS, and MACS, we found a sizable and significant deviation from the general population mean regarding cardiac structure and function. Even mild cortisol excess is associated with glucocorticoid-induced cardiac alterations, which appear to persist despite long-term biochemical remission.
Study context
- Population
- Patients with endogenous cortisol excess (overt cushing's syndrome (CS), biochemically cured CS, mild autonomous cortisol secretion (MACS)) compared with the general population of Würzburg
- Participants
- 40 / 56 / 18 / 4,965
- Exposure
- Overt CS, cured CS and MACS vs general population
- Overt CSn = 40
- Cured CSn = 56
- MACSn = 18
- General populationn = 4,965reference
- Outcome
- Cardiac structure and function (echocardiography)
Main finding
As reported in the abstract
- Overt CS was associated with left ventricular (LV) remodeling along with hypertrophy and impaired longitudinal systolic/diastolic function
- In MACS, cardiac remodeling was even more pronounced than in individuals with metabolic syndrome
Observational data: associations, not effects.
Further findings
Median, ms-1
| Outcome | Cured CS | General population | P value |
|---|---|---|---|
| LV relaxation velocity e' (diastolic function), previous CS vs general population · median time of biochemical remission: 95 [36, 201] monthsWorse diastolic function with previous CS | 0.08 (IQR 0.07–0.10) | 0.10 (IQR 0.08–0.12) | P < 0.001 |
Follow-up after biochemical remission (20 CS patients) · median of 8 (quartiles: 6, 11) months
- Hypertension and hyperglycemia better controlled, while cardiac alterations only partially improved
Original publication
Cardiovascular status in endogenous cortisol excess: the prospective CV-CORT-EX study. Eur J Endocrinol. Published 18 November 2024. doi:10.
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