Department of Endocrinology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Endocrine. 2024 Nov;86(2):841-849. doi: 10.1007/s12020-024-03980-4. Epub 2024 Jul 29.
Two-dimensional speckle tracking echocardiography is a novel ultrasound technique, which can detect early subclinical myocardial dysfunction with high sensitivity. The purpose of this study was to explore the value of speckle tracking echocardiography in the evaluation of subclinical myocardial injury in patients with Cushing's syndrome.
35 patients with Cushing's syndrome and 29 healthy controls matched for age, sex, BMI, and systolic blood pressure were included in the study. All subjects were assessed using both conventional Doppler echocardiography and speckle tracking echocardiography. Among patients, they were further divided into inactive group (n = 7) and active group (n = 28) based on cortisol levels. Trend analysis was used among patients in different disease activity. Correlation analysis and linear regression analysis were used to explore influence factors related to subclinical myocardial dysfunction.
Left ventricular ejection fraction value showed no statistical difference between patients Cushing's syndrome and control group. However, GLS and LVSD, show significant differences in Cushing's syndrome group. Also, among active Cushing's syndrome group, inactive Cushing's syndrome group and control group, GLS (-15.4 ± 3.0 vs -18.1 ± 3.1 vs-19.4 ± 2.4, P < 0001) and LVSD (48.9 ± 21.5 vs 43.5 ± 17.9 vs 28.5 ± 8.3, P < 0001) changed significantly with the disease activity status. In addition, GLS and LVSD were both linearly corrected with 24-hour urinary cortisol level.
GLS and LVSD are sensitive parameters in detecting and monitoring subclinical myocardial systolic dysfunction in patients with Cushing's syndrome. Myocardial injury is linearly correlated with cortisol level, which can be partially reversed after the biochemical control of cortisol.
二维斑点追踪超声心动图是一种新型超声技术，能够高灵敏度地检测早期亚临床心肌功能障碍。本研究旨在探讨斑点追踪超声心动图在评估库欣综合征患者亚临床心肌损伤中的价值。
本研究纳入 35 例库欣综合征患者和 29 例年龄、性别、BMI 和收缩压相匹配的健康对照者。所有患者均接受常规多普勒超声心动图和斑点追踪超声心动图检查。根据皮质醇水平，患者进一步分为无活性组（n=7）和活性组（n=28）。对不同疾病活动度的患者进行趋势分析。采用相关分析和线性回归分析探讨与亚临床心肌功能障碍相关的影响因素。
库欣综合征患者与对照组左心室射血分数值无统计学差异，但 GLS 和 LVSD 在库欣综合征组有显著差异。此外，在活性库欣综合征组、无活性库欣综合征组和对照组中，GLS（-15.4±3.0 比-18.1±3.1 比-19.4±2.4，P<0.0001）和 LVSD（48.9±21.5 比 43.5±17.9 比 28.5±8.3，P<0.0001）随疾病活动状态显著变化。此外，GLS 和 LVSD 均与 24 小时尿皮质醇水平呈线性相关。
GLS 和 LVSD 是检测和监测库欣综合征患者亚临床心肌收缩功能障碍的敏感参数。心肌损伤与皮质醇水平呈线性相关，皮质醇的生化控制可部分逆转。
