Key result
Adrenalectomy in three patients with Cushing's syndrome resulted in complete regression of severe disproportionate hypertrophy of the interventricular septum and normalization of ECG findings.
Why the study?
Does adrenalectomy improve left ventricular hypertrophy in patients with Cushing's syndrome?
Case Report (n=3)
No
Does adrenalectomy improve left ventricular hypertrophy in patients with Cushing's syndrome?
Adrenalectomy can lead to complete regression of severe disproportionate hypertrophy of the interventricular septum in patients with Cushing's syndrome, suggesting excessive plasma cortisol as an etiologic factor.
Adrenalectomy may reverse septal hypertrophy in Cushing syndrome; hypothesis-generating case series leaves open cortisol causality and needs prospective confirmation.
Three patients of Cushing's syndrome with severe disproportionate hypertrophy of the interventricular septum are reported. All three underwent adrenalectomy and the diagnosis of Cushing's syndrome was confirmed by the presence of adrenal adenoma. All three showed hypertension before the adrenalectomy and two remained hypertensive following adrenalectomy. Before the operations the electrocardiograms revealed inverted T waves in broad leads, and mechanocardiogram systolic and diastolic dysfunction. After the adrenalectomies, abnormal findings on electrocardiograms were normalized and septal hypertrophy was completely regressed. It appears that not only high aortic pressure but also excessive plasma cortisol may be an etiologic factor of the left ventricular hypertrophy in Cushing's syndrome.
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Sugihara et al. (1992) conducted a case report in Cushing's syndrome with severe disproportionate hypertrophy of the interventricular septum (n=3). Adrenalectomy vs. Pre-operative baseline was evaluated on Regression of septal hypertrophy. Adrenalectomy in three patients with Cushing's syndrome resulted in complete regression of severe disproportionate hypertrophy of the interventricular septum and normalization of ECG findings.
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