The patient’s sex determines the hemodynamic profile in patients with Cushing disease
BackgroundCushing disease (CD) may lead to accelerated cardiovascular remodeling and increased mortality. There are suspected differences in the mechanism of cardiovascular dysfunction between males and females with CD. The purpose of this study was to assess the effect of patient sex on the hemodyn...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1270455/full |
| _version_ | 1827795742145642496 |
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| author | Agnieszka Jurek Paweł Krzesiński Beata Uziębło-Życzkowska Przemysław Witek Grzegorz Zieliński Anna Kazimierczak Robert Wierzbowski Małgorzata Banak Grzegorz Gielerak |
| author_facet | Agnieszka Jurek Paweł Krzesiński Beata Uziębło-Życzkowska Przemysław Witek Grzegorz Zieliński Anna Kazimierczak Robert Wierzbowski Małgorzata Banak Grzegorz Gielerak |
| author_sort | Agnieszka Jurek |
| collection | DOAJ |
| description | BackgroundCushing disease (CD) may lead to accelerated cardiovascular remodeling and increased mortality. There are suspected differences in the mechanism of cardiovascular dysfunction between males and females with CD. The purpose of this study was to assess the effect of patient sex on the hemodynamic profile assessed via impedance cardiography and echocardiography in patients newly diagnosed with CD.Material and methodsThe 54 patients newly diagnosed with CD (mean age 41 years; 77.8% of females) who were included in this prospective clinical study underwent impedance cardiography to assess specific parameters (including systemic vascular resistance index [SVRI], total arterial compliance index [TACI], Heather index [HI], stroke index [SI], cardiac index [CI], velocity index [VI], and acceleration index [ACI]) and transthoracic echocardiography to assess heart chamber diameters and left ventricular systolic and diastolic function.ResultsMales with CD exhibited higher afterload, with higher SVRI (3,169.3 ± 731.8 vs. 2,339.3 ± 640.8 dyn*s*cm-5*m² in males and females, respectively; p=0.002), lower TACI (0.80 ± 0.30 vs. 1.09 ± 0.30 mL/mmHg*m2; p=0.008), and lower hemodynamic parameters of left ventricular function, with lower HI (9.46 ± 2.86 vs. 14.1 ± 5.06 Ohm/s2; p=0.0007), lower VI (35.1 ± 11.9 vs. 44.9 ± 13.1 1*1000-1*s-1; p=0.009), lower SI (36.5 ± 11.7 vs. 43.6 ± 9.57 mL/m2; p=0.04), lower CI (2.36 ± 0.46 vs. 3.17 ± 0.76 mL*m-2*min-1; p=0.0009), and lower ACI (50.4 ± 19.8 vs. 73.6 ± 25.0 1/100/s2; p=0.006). There were no significant differences between the sexes in left ventricular systolic or diastolic function assessed by echocardiography.ConclusionIn comparison with females with CD, males with CD have a less favorable hemodynamic profile, with higher afterload and worse left ventricular function. Sex differences in cardiovascular system function should be taken into consideration in designing personalized diagnostic and therapeutic management of patients with CD. |
| first_indexed | 2024-03-11T18:54:47Z |
| format | Article |
| id | doaj.art-921a86ca52a4448fa90a4a413825bffe |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-03-11T18:54:47Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-921a86ca52a4448fa90a4a413825bffe2023-10-11T06:56:00ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-10-011410.3389/fendo.2023.12704551270455The patient’s sex determines the hemodynamic profile in patients with Cushing diseaseAgnieszka Jurek0Paweł Krzesiński1Beata Uziębło-Życzkowska2Przemysław Witek3Grzegorz Zieliński4Anna Kazimierczak5Robert Wierzbowski6Małgorzata Banak7Grzegorz Gielerak8Department of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, PolandDepartment of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, PolandDepartment of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, PolandDepartment of Internal Medicine, Endocrinology, and Diabetes, Medical University of Warsaw, Warsaw, PolandDepartment of Neurosurgery, Military Institute of Medicine – National Research Institute, Warsaw, PolandDepartment of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, PolandDepartment of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, PolandDepartment of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, PolandDepartment of Cardiology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, PolandBackgroundCushing disease (CD) may lead to accelerated cardiovascular remodeling and increased mortality. There are suspected differences in the mechanism of cardiovascular dysfunction between males and females with CD. The purpose of this study was to assess the effect of patient sex on the hemodynamic profile assessed via impedance cardiography and echocardiography in patients newly diagnosed with CD.Material and methodsThe 54 patients newly diagnosed with CD (mean age 41 years; 77.8% of females) who were included in this prospective clinical study underwent impedance cardiography to assess specific parameters (including systemic vascular resistance index [SVRI], total arterial compliance index [TACI], Heather index [HI], stroke index [SI], cardiac index [CI], velocity index [VI], and acceleration index [ACI]) and transthoracic echocardiography to assess heart chamber diameters and left ventricular systolic and diastolic function.ResultsMales with CD exhibited higher afterload, with higher SVRI (3,169.3 ± 731.8 vs. 2,339.3 ± 640.8 dyn*s*cm-5*m² in males and females, respectively; p=0.002), lower TACI (0.80 ± 0.30 vs. 1.09 ± 0.30 mL/mmHg*m2; p=0.008), and lower hemodynamic parameters of left ventricular function, with lower HI (9.46 ± 2.86 vs. 14.1 ± 5.06 Ohm/s2; p=0.0007), lower VI (35.1 ± 11.9 vs. 44.9 ± 13.1 1*1000-1*s-1; p=0.009), lower SI (36.5 ± 11.7 vs. 43.6 ± 9.57 mL/m2; p=0.04), lower CI (2.36 ± 0.46 vs. 3.17 ± 0.76 mL*m-2*min-1; p=0.0009), and lower ACI (50.4 ± 19.8 vs. 73.6 ± 25.0 1/100/s2; p=0.006). There were no significant differences between the sexes in left ventricular systolic or diastolic function assessed by echocardiography.ConclusionIn comparison with females with CD, males with CD have a less favorable hemodynamic profile, with higher afterload and worse left ventricular function. Sex differences in cardiovascular system function should be taken into consideration in designing personalized diagnostic and therapeutic management of patients with CD.https://www.frontiersin.org/articles/10.3389/fendo.2023.1270455/fullCushing diseaseimpedance cardiographyhemodynamic profilecardiovascular complicationsechocardiography |
| spellingShingle | Agnieszka Jurek Paweł Krzesiński Beata Uziębło-Życzkowska Przemysław Witek Grzegorz Zieliński Anna Kazimierczak Robert Wierzbowski Małgorzata Banak Grzegorz Gielerak The patient’s sex determines the hemodynamic profile in patients with Cushing disease Frontiers in Endocrinology Cushing disease impedance cardiography hemodynamic profile cardiovascular complications echocardiography |
| title | The patient’s sex determines the hemodynamic profile in patients with Cushing disease |
| title_full | The patient’s sex determines the hemodynamic profile in patients with Cushing disease |
| title_fullStr | The patient’s sex determines the hemodynamic profile in patients with Cushing disease |
| title_full_unstemmed | The patient’s sex determines the hemodynamic profile in patients with Cushing disease |
| title_short | The patient’s sex determines the hemodynamic profile in patients with Cushing disease |
| title_sort | patient s sex determines the hemodynamic profile in patients with cushing disease |
| topic | Cushing disease impedance cardiography hemodynamic profile cardiovascular complications echocardiography |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1270455/full |
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