Key result
Pheochromocytoma is linked to ~18% higher LVMI versus Takotsubo cardiomyopathy, while both share QTc prolongation.
Why the study?
Excessive catecholamine causes alterations in cardiac structure and function, but differences in LVH and QTc prolongation between pheochromocytoma and Takotsubo cardiomyopathy remained to be evaluated.
Are there differences in left ventricular hypertrophy and QTc prolongation between patients with pheochromocytoma and Takotsubo cardiomyopathy?
Observational (n=40)
No
Are there differences in left ventricular hypertrophy and QTc prolongation between patients with pheochromocytoma and Takotsubo cardiomyopathy?
Absolute Event Rate: 133.3% vs 113.3%
p-value: p=0.031
Pheochromocytoma is associated with more prominent left ventricular hypertrophy compared to Takotsubo cardiomyopathy, though both conditions frequently cause QTc prolongation.
LV mass assessment may aid pheochromocytoma differentiation from Takotsubo; leaves open QTc prognostic value in catecholamine excess.
BACKGROUND AND OBJECTIVES: Excessive catecholamine causes the alteration of cardiac structure and function. This study evaluated if there is any difference in left ventricular hypertrophy (LVH) and QTc prolongation in conditions with pheochromocytoma and Takotsubo cardiomyopathy (TC). SUBJECTS AND METHODS: We reviewed the medical records of 20 pheochromocytoma patients for cardiovascular events prior to diagnosis. The patient's clinical history and electrocardiographic and echocardiographic findings were compared to those of 20 patients diagnosed with TC. RESULTS: Left ventricular (LV) mass index (133.3±37.8 vs. 113.3±17.3, p=0.031), relative wall thickness (0.55±0.15 vs. 0.47±0.07, p=032) and elevated blood pressure (BP) were more prominent in pheochromocytoma compared to TC. The mean creatinine kinase-MB elevation, reduced LV systolic function and ST segment changes were more prominent in the TC group compared to the pheochromocytoma groups (all p<0.05). The prevalence of QTc prolongation was high in patients with pheochromocytoma (45%) and TC (55%), and TC male patients appeared to have a more prolonged QTc interval. Urine epinephrine (r=0.844, p=0.004) and norepinephrine level (r=0.782, p=0.013) were significantly correlated with LV mass index, and the predictors for the QTc prolongation were male gender and the presence of LVH. CONCLUSION: A prolonged QTc was prominent in pheochromocytoma and TC regardless of BP and systolic LV function, and LVH was more prominent in pheochromocytoma than TC.
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Choi et al. (2014) conducted an observational in Pheochromocytoma and Takotsubo cardiomyopathy (n=40). Pheochromocytoma vs. Takotsubo cardiomyopathy was evaluated on Left ventricular mass index (LVMI) (p=0.031). Pheochromocytoma was associated with a significantly higher left ventricular mass index (133.3 vs. 113.3 g/m2, p=0.031) compared to Takotsubo cardiomyopathy, while QTc prolongation was prominent in both.
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