Purpose
Cushing’s syndrome has demonstrated infraclinical myocardial involvement such as left ventricular hypertrophy and both diastolic and systolic impairment1.
Myocardial fibrosis may be an important determinant of myocardial dysfunction in this condition2. However,
newT1 mapping techniques have not yet been reported to assess this hypothesis and to evaluate its usefulness for diagnosis and for treatment follow-up.
Methods and Materials
This is a longitudinal pilot study performed in an academic center from Sept 2009 to Jan 2013.
Ten consecutive patients with active Cushing’s disease (CD) were included and matched with ten healthy volunteers on age,
sex and heart rate.
Inclusion criteria were: age between 15 and 60 years and Cushing's syndrome of pitutary origin newly diagnosed and untreated.
Patients and volunteers had a cardiac MRI exam shortly after diagnosis and a follow-up exam on average 6 month after cortisol normalization obtained by pituitary adenoma resection....
Results
All Patients’ characteristics at baseline and after treatment are summarized in table 1.
Ten patients aged 36±15 years (9 women,
1 man) were included and matched to ten controls on age (36±9 years),
sex and heart rate. BMI of patients and controls were not significantly different (p=0.080),
but systolic and diastolic pressures were increased in patient which is expected in this disease (120±14 vs.
100±13,
p=0.002 and 75±10 vs.
73±34,
p=0.023 respectively).
Morphological and functional parameters,
T1,
λ before and after contrast are summarized in...
Conclusion
Native T1 map is a potential tool to diagnose CD cardiac involvement and follow treatment efficacy with high sensitivity,
beyond measures of global LV geometry and function.
The value of T1 after gadolinium enhancement is not yet clear and needs further studies.
Our results may indirectly suggest the role of myocardial steatosis in this pathology.
References
1.
Muiesan,
M.
L.
et al. Left ventricular structural and functional characteristics in Cushing’s syndrome.
J.
Am.
Coll.
Cardiol. 41, 2275–2279 (2003).
2.
Yiu,
K.
H.
et al. Increased myocardial fibrosis and left ventricular dysfunction in Cushing’s syndrome.
Eur.
J.
Endocrinol. 166, 27–34 (2011).
3. Kellman,
P.,
Wilson,
J.
R.,
Xue,
H.,
Ugander,
M.
& Arai,
A.
E.
Extracellular volume fraction mapping in the myocardium,
part 1: evaluation of an automated method.
J Cardiovasc Magn Reson 14, 63 (2012).
4.Sado,
D.
M.
et al. Identification...
