Liu L, Li X, Ma W, Fan F, Yang Y, Zhang L, Yi T, Zhang J, Guo J, Gao Y
Department of Endocrinolgy, Peking University First Hospital, Xishiku Street, Beijing, 100034, Xicheng District, China.
Department of Cardiology, Peking University First Hospital, Xishiku Street, Beijing, 100034, Xicheng District, China.
J Endocrinol Invest. 2025 Jun 9. doi: 10.1007/s40618-025-02594-5.
Speckle tracking echocardiography (STE) provides a quantitative assessment of left ventricular systolic performance, including myocardial motion and deformation. Global longitudinal strain (GLS) is a reliable and sensitive indicator of systolic function, with clinical and prognostic value in various settings, including secondary hypertension. There is limited data on GLS evaluation in patients with non-functioning adrenal adenomas (NF), despite emerging evidence suggesting its association with subclinical cardiovascular dysfunction. Investigating the cardiac impact of NF is essential for understanding its role in early cardiac remodeling compared to primary aldosteronism (PA) and essential hypertension (EH).
To retrospectively evaluate the utility of GLS in detecting early cardiac dysfunction in patients with NF, PA, and EH without adrenal adenoma or hyperplasia.
This retrospective study included 33 patients with NF, 33 with PA, and 33 with EH, matched by gender and age. Speckle tracking echocardiography was used to assess the GLS of the left ventricle. Data analysis was conducted using IBM SPSS Statistics version 29.0, with a significance threshold set at P < 0.050.
The GLS in NF patients (-20.63 ± 3.10%) was significantly lower than in EH patients (-22.17 ± 3.03%) but higher than in PA patients (-18.55 ± 2.45%), despite NF patients having the lowest prevalence of hypertension and systolic blood pressure. GLS was significantly correlated with cortisol levels, impaired glucose tolerance, and ARR across all patient groups, highlighting the complex interplay between metabolic and hormonal factors in cardiac dysfunction.
Cardiac function impairment in NF patients lies between that observed in EH and PA patients, suggesting a nuanced impact of non-functioning adrenal adenomas on cardiac health.
斑点追踪超声心动图（STE）可对左心室收缩功能进行定量评估，包括心肌运动和变形。整体纵向应变（GLS）是收缩功能的可靠且敏感指标，在包括继发性高血压在内的各种情况下都具有临床和预后价值。尽管有新证据表明非功能性肾上腺腺瘤（NF）与亚临床心血管功能障碍有关，但关于NF患者GLS评估的数据有限。研究NF对心脏的影响对于理解其在与原发性醛固酮增多症（PA）和原发性高血压（EH）相比的早期心脏重塑中的作用至关重要。
回顾性评估GLS在检测NF、PA和无肾上腺腺瘤或增生的EH患者早期心脏功能障碍中的效用。
这项回顾性研究纳入了33例NF患者、33例PA患者和33例EH患者，按性别和年龄匹配。采用斑点追踪超声心动图评估左心室的GLS。使用IBM SPSS Statistics 29.0版进行数据分析，显著性阈值设定为P < 0.050。
NF患者的GLS（-20.63±3.10%）显著低于EH患者（-22.17±3.03%），但高于PA患者（-18.55±2.45%），尽管NF患者的高血压患病率和收缩压最低。在所有患者组中，GLS与皮质醇水平、糖耐量受损和ARR显著相关，突出了代谢和激素因素在心脏功能障碍中的复杂相互作用。
NF患者的心脏功能损害介于EH和PA患者之间，表明非功能性肾上腺腺瘤对心脏健康有细微影响。
