Key result
Male sex in new Cushing disease linked to ~35% higher systemic vascular resistance than females.
Why the study?
Cushing disease may cause accelerated cardiovascular remodeling and increased mortality, with suspected differences in cardiovascular dysfunction mechanisms between males and females.
Does patient sex affect the hemodynamic profile in patients newly diagnosed with Cushing disease?
Observational (n=54)
No
Does patient sex affect the hemodynamic profile in patients newly diagnosed with Cushing disease?
Males newly diagnosed with Cushing disease have a less favorable hemodynamic profile with higher afterload and worse left ventricular function compared to females, suggesting a need for sex-specific cardiovascular risk management.
Answers are grounded in this paper and cite their sources.
Sex differences in afterload and LV function may inform risk stratification in Cushing disease; this cohort study leaves open whether they affect outcomes or warrant intervention.
Background Cushing 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 methods The 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. Results Males 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*m 2 ; p=0.008), and lower hemodynamic parameters of left ventricular function, with lower HI (9.46 ± 2.86 vs. 14.1 ± 5.06 Ohm/s 2 ; 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/m 2 ; 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/s 2 ; p=0.006). There were no significant differences between the sexes in left ventricular systolic or diastolic function assessed by echocardiography. Conclusion In 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.
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Jurek et al. (2023) conducted an observational in Cushing disease (n=54). Male sex vs. Female sex was evaluated on Systemic vascular resistance index (SVRI) (p=0.002). Males newly diagnosed with Cushing disease had a less favorable hemodynamic profile than females, with a significantly higher systemic vascular resistance index (3,169.3 vs. 2,339.3 dyn*s*cm-5*m²).
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