Bisogni Valeria, Petramala Luigi, Oliviero Gaia, Bonvicini Maria, Mezzadri Martina, Olmati Federica, Concistrè Antonio, Saracino Vincenza, Celi Monia, Tonnarini Gianfranco, Iannucci Gino, De Toma Giorgio, Ciardi Antonio, La Torre Giuseppe, Letizia Claudio
Department of Translational and Precision Medicine, Unit of Secondary Arterial Hypertension, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy.
Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Viale del Policlinico 155, 00165 Rome, Italy.
Cancers (Basel). 2019 May 12;11(5):658. doi: 10.3390/cancers11050658.
Data on short-term blood pressure variability (BPV), which is a well-established cardiovascular prognostic tool, in pheochromocytoma and paraganglioma (PPGL) patients is still lack and conflicting. We retrospectively evaluated 23 PPGL patients referred to our unit from 2010 to 2019 to analyze 24 h ambulatory blood pressure monitoring (24-h ABPM)-derived markers of short-term BPV, before and after surgical treatment. PPGL diagnosis was assessed according to guidelines and confirmed by histologic examination. The 24-h ABPM-derived markers of short-term BPV included: circadian pressure rhythm; standard deviation (SD) and weighted SD (wSD) of 24-h, daytime, and night-time systolic and diastolic blood pressure (BP); average real variability (ARV) of 24-h, daytime, and night-time systolic and diastolic BP. 7 males and 16 females of 53 ± 18 years old were evaluated. After surgical resection of PPGL we found a significant decrease in 24-h systolic BP ARV (8.8 ± 1.6 vs. 7.6 ± 1.3 mmHg, < 0.001), in 24-h diastolic BP ARV (7.5 ± 1.6 vs. 6.9 ± 1.4 mmHg, = 0.031), and in wSD of 24-h diastolic BP (9.7 ± 2.0 vs 8.8 ± 2.1 mmHg, = 0.050) comparing to baseline measurements. Moreover, baseline 24-h urinary metanephrines significantly correlated with wSD of both 24-h systolic and diastolic BP. Our study highlights as PPGL patients, after proper treatment, show a significant decrease in some short-term BPV markers, which might represent a further cardiovascular risk factor.
作为一种成熟的心血管预后工具，嗜铬细胞瘤和副神经节瘤（PPGL）患者的短期血压变异性（BPV）数据仍然匮乏且存在矛盾。我们回顾性评估了2010年至2019年转诊至我科的23例PPGL患者，以分析手术治疗前后24小时动态血压监测（24-h ABPM）得出的短期BPV指标。PPGL诊断根据指南进行评估，并通过组织学检查确认。24-h ABPM得出的短期BPV指标包括：昼夜血压节律；24小时、白天和夜间收缩压和舒张压（BP）的标准差（SD）和加权标准差（wSD）；24小时、白天和夜间收缩压和舒张压的平均实际变异性（ARV）。评估了7名男性和16名女性，年龄53±18岁。PPGL手术切除后，我们发现与基线测量相比，24小时收缩压ARV显著降低（8.8±1.6 vs. 7.6±1.3 mmHg，<0.001），24小时舒张压ARV显著降低（7.5±1.6 vs. 6.9±1.4 mmHg，=0.031），24小时舒张压wSD显著降低（9.7±2.0 vs 8.8±2.1 mmHg，=0.050）。此外，基线24小时尿间甲肾上腺素与24小时收缩压和舒张压的wSD均显著相关。我们的研究强调，PPGL患者经过适当治疗后，一些短期BPV指标显著降低，这可能代表了一种进一步的心血管危险因素。
