Cardiovascular Status in Patients With Endogenous Cortisol Excess (Cushing's Syndrome)

Endogenous Cushing's syndrome (CS) is associated with increased cardiovascular (CV) morbidity and reduced general health status. It has been shown that these impairments may be reversible after cure of hypercortisolism. However, previous studies were restricted to selected CV aspects.

The primary aim of the CV-CORT-EX study is to comprehensively assess left ventricular function and morphology of patients with endogenous CS. Secondly, we examine long-term changes of CV function, endothelial function, psychosocial status, bio-impedance, and quality of life.

Within the longitudinal study, patients will be investigated at initial diagnosis and at least 6 months after cure of CS. Within the cross-sectional study, we aim to comprehensively phenotype patients with endogenous CS and unknown CV disease. Results will finally be compared with healthy controls.

Inclusion criteria

• Written informed consent
• Age ≥18 years
• Cross-sectional study:History of clinically and biochemically proven endogenous Cushing's syndrome (overt or subclinical)
• Longitudinal study: Patients with clinically and biochemically proven endogenous Cushing's syndrome (initial diagnosis or recurrent disease)

Exclusion criteria

• Glucocorticoid pharmacotherapy for >12 months within the previous 3 years
• Structural heart disease, chronic heart failure (>NYHAII), systemic or single organ disease potentially affecting cardiac function
• Arterial hypertension (uncontrolled with >3 antihypertensive drugs)
• Pregnancy
• Drug abuse
• Cardiac Magnetic Resonance Imaging (cMRI) substudy: patients with renal failure are excluded from the cMRI study (MDRD <60)