Impact of Pheochromocytoma on Left Ventricular Hypertrophy and QTc Prolongation: Comparison with Takotsubo Cardiomyopathy

Korean Circulation Journal 2014³â 44±Ç 2È£ p.89 ~ p.96

ÃÖ¼±À±(Choi Seon-Yoon) - Kosin University College of Medicine Cardiovascular Research Institute
Á¶°æÀÓ(Cho Kyoung-Im) - Kosin University College of Medicine Cardiovascular Research Institute
ÇÑÀ¯Áø(Han You-Jin) - Kosin University College of Medicine Cardiovascular Research Institute
À¯°¡ÀÎ(You Ga-In) - Kosin University College of Medicine Cardiovascular Research Institute
±èÁ¦ÈÆ(Kim Je-Hun) - Kosin University College of Medicine Cardiovascular Research Institute
ÇãÁ¤È£(Heo Jeong-Ho) - Kosin University College of Medicine Cardiovascular Research Institute
±èÇö¼ö(Kim Hyun-Soo) - Kosin University College of Medicine Cardiovascular Research Institute
Â÷ÅÂÁØ(Cha Tae-Joon) - Kosin University College of Medicine Cardiovascular Research Institute
ÀÌÀç¿ì(Lee Jae-Woo) - Kosin University College of Medicine Cardiovascular Research Institute

Abstract

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¡¾37.8 vs. 113.3¡¾17.3, p=0.031), relative wall thickness (0.55¡¾0.15 vs. 0.47¡¾0.07, 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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Long QT syndrome, Hypertrophy, left ventricular, Catecholamines
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