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Increased arterial rigidity in children affected by Cushing’s syndrome after successful surgical cure

Published online by Cambridge University Press:  21 May 2010

Pier Paolo Bassareo ,
Andrea Raffaele Marras ,
Daniele Pasqualucci  and
Giuseppe Mercuro
Pier Paolo Bassareo*
Affiliation:
Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy
Andrea Raffaele Marras
Affiliation:
Study Center for Cardiac Disease in Paediatric Age, University of Cagliari, Cagliari, Italy
Daniele Pasqualucci
Affiliation:
Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy
Giuseppe Mercuro
Affiliation:
Department of Cardiovascular and Neurological Sciences, University of Cagliari, Cagliari, Italy
*
Correspondence to: P. P. Bassareo, MD, Department of Cardiovascular and Neurological Sciences, University of Cagliari, Policlinico Universitario, S.S. 554, bivio di Sestu – 09042 Monserrato (Cagliari), Italy. Tel: +39 070 675 4953; Fax: +39 070 675 4953; E-mail: piercard@inwind.it
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Abstract

Background

Complications, such as secondary hypertension, probably related to the loss of arterial elasticity, frequently arise in Cushing’s syndrome, and may persist even beyond cure. This study aimed at demonstrating that arterial compliance, evaluated by automated recording of the QKd interval, was lower in children after a successful surgery for Cushing’s syndrome than in a control group of healthy subjects.

Methods

In all, 23 young girls aged between 11 and 18 years who had undergone a surgical cure for Cushing syndrome – 18 with a pituitary adenoma, three with a primary adrenal disease, and two suffering from ectopic adrenocorticotrope hormone secretion – were enrolled. Arterial stiffness was measured by the standardised non-invasive QKd 100-60 method. A 24-hour ambulatory blood pressure monitoring and a transthoracic echocardiography were also performed.

Results

The children operated for Cushing’s syndrome showed disadvantageous differences in 24-hour ambulatory blood pressure monitoring and in QKD 100-60 value, with p less than 0.01, compared with the control group.

Conclusions

In spite of its successful surgical cure, Cushing’s syndrome results in a significantly decreased arterial distensibility when compared with the control group, which might explain these differences in blood pressure levels. It underlines a significantly higher cardiovascular risk, notwithstanding both the normalisation of cortisol secretion and the very early age of the patients.

Keywords

Arterial complianceQkd intervalhypertensionprognostic tests
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 6 , December 2010 , pp. 610 - 614
Copyright
Copyright © Cambridge University Press 2010

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