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肾上腺切除术对嗜铬细胞瘤患者亚临床左心室功能障碍缓解的影响：一项斑点追踪超声心动图研究

Effect of adrenalectomy on remission of subclinical left ventricular dysfunction in patients with pheochromocytoma: a speckle-tracking echocardiography study.

作者信息

Kvasnička Jan, Petrák Ondřej, Zelinka Tomáš, Klímová Judita, Kološová Barbora, Novák Květoslav, Michalský David, Widimský Jiří, Holaj Robert

机构信息

3rd Department of Medicine, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, Praha, Czech Republic.

Department of Urology, General University Hospital and 1st Faculty of Medicine, Charles University in Prague, Praha, Czech Republic.

出版信息

Endocr Connect. 2021 Nov 29;10(12):1538-1549. doi: 10.1530/EC-21-0462.

DOI:10.1530/EC-21-0462
PMID:34734567
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8679879/
Abstract

BACKGROUND

Pheochromocytomas (PHEO) are tumours with the ability to produce, metabolize and secrete catecholamines. Catecholamines overproduction leads to the decrease of longitudinal function of the left ventricle (LV) measured by speckle-tracking echocardiography. Patients with PHEO have a lower magnitude of global longitudinal strain (GLS) than patients with essential hypertension. GLS normalization is expected after resolution of catecholamine overproduction.

METHODS

Twenty-four patients (14 females and 10 males) with a recent diagnosis of PHEO have been examined before and 1 year after adrenalectomy. An echocardiographic examination including speckle-tracking analysis with the evaluation of GLS and regional longitudinal strain (LS) in defined groups of LV segments (basal, mid-ventricular and apical) was performed.

RESULTS

One year after adrenalectomy, the magnitude of GLS increased (-14.3 ± 1.8 to -17.7 ± 1.6%; P < 0.001). When evaluating the regional LS, the most significant increase in the differences was evident in the apical segment compared to mid-ventricular and basal segments of LV (-5.4 ± 5.0 vs -1.9 ± 2.7 vs -1.6 ± 3.8; P < 0.01).

CONCLUSIONS

In patients with PHEO, adrenalectomy leads to an improvement of subclinical LV dysfunction represented by the increasing magnitude of GLS, which is the most noticeable in apical segments of LV.

摘要

背景

嗜铬细胞瘤（PHEO）是能够产生、代谢和分泌儿茶酚胺的肿瘤。儿茶酚胺分泌过多会导致经斑点追踪超声心动图测量的左心室（LV）纵向功能下降。与原发性高血压患者相比，PHEO患者的整体纵向应变（GLS）幅度更低。儿茶酚胺分泌过多情况得到缓解后，预计GLS会恢复正常。

方法

对24例近期诊断为PHEO的患者（14例女性和10例男性）在肾上腺切除术前及术后1年进行了检查。进行了超声心动图检查，包括斑点追踪分析，以评估GLS以及左心室特定节段组（基底段、心室中段和心尖段）的区域纵向应变（LS）。

结果

肾上腺切除术后1年，GLS幅度增加（从-14.3±1.8至-17.7±1.6%；P<0.001）。在评估区域LS时，与左心室的心室中段和基底段相比，心尖段的差异增加最为显著（-5.4±5.0 vs -1.9±2.7 vs -1.6±3.8；P<0.01）。

结论

在PHEO患者中，肾上腺切除术可改善以GLS幅度增加为代表的亚临床左心室功能障碍，这在左心室心尖段最为明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/662c4480c6c2/EC-21-0462fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/d6c7d71a1aaa/EC-21-0462fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/e7de73f809f5/EC-21-0462fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/87040bfdf92b/EC-21-0462fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/662c4480c6c2/EC-21-0462fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/d6c7d71a1aaa/EC-21-0462fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/e7de73f809f5/EC-21-0462fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/87040bfdf92b/EC-21-0462fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aec0/8679879/662c4480c6c2/EC-21-0462fig4.jpg

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