■库欣综合征(CS)与心力衰竭的风险增加有关,通常最初表现为左心室舒张功能障碍(LVDD)。在这项研究中,我们旨在通过纳入身体成分参数来探索CS中LVDD的潜在危险因素。
■对诊断为不小于18岁的内源性CS的患者进行了回顾性研究。对照组由与CS患者性别相匹配的健康个体组成,年龄,BMI。应用LIFEx软件(7.3版)在非对比胸部CT上测量心外膜脂肪组织体积(EATV),以及第一腰椎水平的腹部脂肪组织和骨骼肌质量。超声心动图用于评估左心室(LV)舒张功能。检查了与早期LVDD有关的身体成分和临床数据。
■共纳入86例CS患者和86例健康对照。与对照组相比,CS患者的EATV明显更高(150.33cm3[125.67,189.41]vs90.55cm3[66.80,119.84],p<0.001)。与健康的患者相比,CS患者的内脏脂肪明显增加,但骨骼肌减少。根据E/A比评估的LV舒张功能,CS患者的LVDD患病率更高(p<0.001)。EATV是CS患者LVDD的独立危险因素(OR=1.015,95CI1.003~1.026,p=0.011)。如果CS患者的EATV切点设置为139.252cm3,LVDD诊断的敏感性和特异性分别为84.00%和55.60%,分别。
■CS与EAT和内脏脂肪的显著积累有关,减少骨骼肌质量,LVDD患病率增加。EATV是LVDD的独立危险因素,提示EAT在CSLVDD发展中的潜在作用。
本研究通过纳入身体成分参数,探索内源性CS中LVDD的潜在危险因素。EATV被确定为LVDD的独立危险因素。减少皮质醇诱导的过度EAT积累的针对性治疗干预措施可能有望减轻CS患者LVDD发展的风险。
UNASSIGNED: Cushing\'s syndrome (CS) is associated with increased risk for heart failure, which often initially manifests as left ventricular diastolic dysfunction (LVDD). In this study, we aimed to explore the potential risk factors of LVDD in CS by incorporating body composition parameters.
UNASSIGNED: A retrospective study was conducted on patients diagnosed with endogenous CS no less than 18 years old. The control group consisted of healthy individuals who were matched to CS patients in terms of gender, age, and BMI. LIFEx software (version 7.3) was applied to measure epicardial adipose tissue volume (EATV) on non-contrast chest CT, as well as abdominal adipose tissue and skeletal muscle mass at the first lumbar vertebral level. Echocardiography was used to evaluate left ventricular (LV) diastolic function. Body compositions and clinical data were examined in relation to early LVDD.
UNASSIGNED: A total of 86 CS patients and 86 healthy controls were enrolled. EATV was significantly higher in CS patients compared to control subjects (150.33 cm3 [125.67, 189.41] vs 90.55 cm3 [66.80, 119.84], p < 0.001). CS patients had noticeably increased visceral fat but decreased skeletal muscle in comparison to their healthy counterparts. Higher prevalence of LVDD was found in CS patients based on LV diastolic function evaluated by E/A ratio (p < 0.001). EATV was proved to be an independent risk factor for LVDD in CS patients (OR = 1.015, 95%CI 1.003-1.026, p = 0.011). If the cut-point of EATV was set as 139.252 cm3 in CS patients, the diagnostic sensitivity and specificity of LVDD were 84.00% and 55.60%, respectively.
UNASSIGNED: CS was associated with marked accumulation of EAT and visceral fat, reduced skeletal muscle mass, and increased prevalence of LVDD. EATV was an independent risk factor for LVDD, suggesting the potential role of EAT in the development of LVDD in CS.
This study explored the potential risk factors of LVDD in endogenous CS by incorporating body composition parameters. EATV was identified as an independent risk factor for LVDD. Targeted therapeutic interventions to reduce excessive cortisol-induced EAT accumulation may be promising to mitigate the risk of LVDD development in patients with CS.