The clinical implication of left ventricular hypertrophy in patients with pheochromocytoma and paraganglioma
10.3760/cma.j.issn.0253-3758.2014.12.011
- VernacularTitle:嗜铬细胞瘤与副神经节瘤患者左心室肥厚的临床意义
- Author:
Li DING
1
;
Ligang FANG
;
Wenling ZHU
;
Zhengpei ZENG
;
Hanzhong LI
Author Information
1. 天津医科大学总医院内分泌科
- Keywords:
Pheochromocytoma;
Paraganglioma;
Cardiomegaly
- From:
Chinese Journal of Cardiology
2014;42(12):1029-1034
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical implications of left ventricular hypertrophy (LVH) in patients with pheochromocytoma and paraganglioma(PH/PGL).Methods Seventy-eight PH/PGL patients receiving medical attention at Peking Union Medical College Hospital from October 2010 to April 2013 were included in the study.Forty-six healthy people who had no hypertension,pathoglycemia,dyslipidemia history,and with normal chest X-ray,electrocardiogram and echocardiography results served as control group.Clinical symptoms and signs,levels of 24-hour urinary catecholamine,electrocardiogram and echocardiography of participants were recorded and analyzed.Results (1) Left ventricular ejection fraction,cardiac output index,left ventricular mass index (LVMI),left atrial volume index (LAVI) and mitral E/E' were all significantly higher while mitral annulus lateral E' velocity was significantly lower in PH/PGL group than in control group(all P ＜ 0.05).(2) LVH was associated with more prevalent acute left-sided heart failure episodes (12％ (3/25)vs.0,P =0.030),sustained LVEF depression (12％ (3/25) vs.0,P =0.030) and ECG ST-T segment alterations (60％ (15/25) vs.21％ (11/53),P =0.001) in PH/PGL patients.LAVI ((30.2 ± 8.8) ml/m2 vs.(23.8 ± 4.7) ml/m2,P =0.007) and mitral E/E' (11.2 ± 6.0 vs.7.2 ± 1.4,P =0.003) were significantly higher in patients with LVH than in patients without LVH.Mitral annulus septal ((7.8 ± 2.6) cm/s vs.(10.4 ± 3.2) cm/s,P =0.001) and lateral ((9.3±3.3) cm/s vs.(12.9±2.9)cm/s,P＜0.001) E' velocity,averaged S' velocity((7.9 ± 1.6) cm/s vs.(8.8 ± 1.7) cm/s,P =0.036) were significantly lower in LVH patients comparing to patients without LVH.(3) According to multiple linear regression analysis,age (t =3.491,P =0.001),gender (t =2.899,P =0.005),heart rate (t =2.255,P =0.027),and 24-hour urinary norepinephrine level (t =3.369,P =0.001) were independent factors affecting LVMI of PH/PGL patients.Conclusion Left ventricular hypertrophy is associated with acute left-sided heart failure,left ventricular diastolic dysfunction and elevated left ventricular filling pressure in PH/PGL patients.
