Comparative analysis of cardiac dysfunction in non-functioning adrenal adenomas, primary aldosteronism, and essential hypertension.

Abstract

Background: Speckle tracking echocardiography (STE) provides a quantitative assessment of left ventricular systolic performance, including myocardial motion and deformation. Global longitudinal strain (GLS) is a reliable and sensitive indicator of systolic function, with clinical and prognostic value in various settings, including secondary hypertension. There is limited data on GLS evaluation in patients with non-functioning adrenal adenomas (NF), despite emerging evidence suggesting its association with subclinical cardiovascular dysfunction. Investigating the cardiac impact of NF is essential for understanding its role in early cardiac remodeling compared to primary aldosteronism (PA) and essential hypertension (EH).

Objective: To retrospectively evaluate the utility of GLS in detecting early cardiac dysfunction in patients with NF, PA, and EH without adrenal adenoma or hyperplasia.

Methods: This retrospective study included 33 patients with NF, 33 with PA, and 33 with EH, matched by gender and age. Speckle tracking echocardiography was used to assess the GLS of the left ventricle. Data analysis was conducted using IBM SPSS Statistics version 29.0, with a significance threshold set at P < 0.050.

Results: The GLS in NF patients (-20.63 ± 3.10%) was significantly lower than in EH patients (-22.17 ± 3.03%) but higher than in PA patients (-18.55 ± 2.45%), despite NF patients having the lowest prevalence of hypertension and systolic blood pressure. GLS was significantly correlated with cortisol levels, impaired glucose tolerance, and ARR across all patient groups, highlighting the complex interplay between metabolic and hormonal factors in cardiac dysfunction.

Conclusion: Cardiac function impairment in NF patients lies between that observed in EH and PA patients, suggesting a nuanced impact of non-functioning adrenal adenomas on cardiac health.