Catecholamines Induce Left Ventricular Subclinical Systolic Dysfunction: A Speckle-Tracking Echocardiography Study.

Jan Kvasnička,Zuzana Krátká,Ondřej Petrák,Tomáš Zelinka,Branislav Štrauch,Alice Markvartová,Ján Rosa,Tomáš Indra,Robert Holaj,Jiří Widimský

doi:10.3390/cancers11030318

Abstract

Background: Pheochromocytomas (PHEO) are tumors arising from chromaffin cells from the adrenal medulla, having the ability to produce, metabolize and secrete catecholamines. The overproduction of catecholamines leads by many mechanisms to the impairment in the left ventricle (LV) function, however, endocardial measurement of systolic function did not find any differences between patients with PHEO and essential hypertension (EH). The aim of the study was to investigate whether global longitudinal strain (GLS) derived from speckle-tracking echocardiography can detect catecholamine-induced subclinical impairments in systolic function. Methods: We analyzed 17 patients (10 females and seven males) with PHEO and 18 patients (nine females and nine males) with EH. The groups did not differ in age or in 24-h blood pressure values. Results: The patients with PHEO did not differ in echocardiographic parameters including LV ejection fraction compared to the EH patients (0.69 ± 0.04 vs. 0.71 ± 0.05; NS), nevertheless, in spackle-tracking analysis, the patients with PHEO displayed significantly lower GLS than the EH patients (−14.8 ± 1.5 vs. −17.8 ± 1.7; p < 0.001). Conclusions: Patients with PHEO have a lower magnitude of GLS than the patients with EH, suggesting that catecholamines induce a subclinical decline in LV systolic function.

Highlights

Pheochromocytomas (PHEO) and functional paragangliomas (PGLs) are rare and mostly non-metastatic tumors originating from chromaffin cells either from the adrenal medulla (PHEO)
The prevalence of PHEO and PGLs in non-selected population of patients with arterial hypertension is between 0.2 and 0.6% [2,3] and the prevalence of PHEO is higher than the prevalence of PGLs, when 80 to 85%
Catecholamines produced by the tumor cells are responsible for a large variety of signs, in particular paroxysmal effects, such as headache, sweating, palpitations, and hypertension because of their effect on Cancers 2019, 11, 318; doi:10.3390/cancers11030318

Summary

Introduction

Pheochromocytomas (PHEO) and functional paragangliomas (PGLs) are rare and mostly non-metastatic tumors originating from chromaffin cells either from the adrenal medulla (PHEO)or from the sympathetic nervous system–associated chromaffin tissue (PGLs) [1]. Pheochromocytomas (PHEO) and functional paragangliomas (PGLs) are rare and mostly non-metastatic tumors originating from chromaffin cells either from the adrenal medulla (PHEO). Of chromaffin-cell tumors are PHEO, whereas 15 to 20% are PGLs [4]. Due to the higher age of the population and smaller tumor sizes at diagnosis, the incidence has increased in recent years [5]. These tumors have the ability to produce, metabolize, and secrete catecholamines. Pheochromocytomas (PHEO) are tumors arising from chromaffin cells from the adrenal medulla, having the ability to produce, metabolize and secrete catecholamines.

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