Pheochromocytoma/paraganglioma-associated cardiomyopathy

Szatko, Alicja; Glinicki, Piotr; Gietka-Czernel, Małgorzata

doi:10.3389/fendo.2023.1204851

Cited by 6 publications

(3 citation statements)

References 88 publications

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“…Catecholamines, including epinephrine, norepinephrine, and dopamine, are tyrosine-derived hormones and neurotransmitters primarily synthesized in the adrenal medulla, sympathetic nerves, and brain. Elevated catecholamine levels can induce vasoconstriction, leading to cardiac injury, HF, myocardial ischemia, and necrosis ( Szatko et al, 2023 ). Persistent catecholamine elevation may cause myocardial calcium overload in cytosolic and mitochondrial compartments, trigger oxidative stress, increase mitochondrial permeability, and cell death ( Szatko et al, 2023 ).…”

Section: The Relationships Between Heart Diseases and Mental Disordersmentioning

confidence: 99%

“…Elevated catecholamine levels can induce vasoconstriction, leading to cardiac injury, HF, myocardial ischemia, and necrosis ( Szatko et al, 2023 ). Persistent catecholamine elevation may cause myocardial calcium overload in cytosolic and mitochondrial compartments, trigger oxidative stress, increase mitochondrial permeability, and cell death ( Szatko et al, 2023 ). In patients with HF, there is an activation of the neuroendocrine systems, particularly the sympathetic nervous system and the renin-angiotensin-aldosterone system, leading to elevated levels of neurohormones such as catecholamines ( Manolis et al, 2023 ).…”

Section: The Relationships Between Heart Diseases and Mental Disordersmentioning

confidence: 99%

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The protective role of ginsenoside Rg3 in heart diseases and mental disorders

Shi,

Luo,

Wei

et al. 2024

Front. Pharmacol.

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Ginsenoside Rg3, a compound derived from Panax ginseng C. A. Mey., is increasingly recognized for its wide range of pharmacological effects. Under the worldwide healthcare challenges posed by heart diseases, Rg3 stands out as a key subject in modern research on Chinese herbal medicine, offering a novel approach to therapy. Mental illnesses are significant contributors to global disease mortality, and there is a well-established correlation between cardiac and psychiatric conditions. This connection is primarily due to dysfunctions in the sympathetic-adrenomedullary system (SAM), the hypothalamic-pituitary-adrenal axis, inflammation, oxidative stress, and brain-derived neurotrophic factor impairment. This review provides an in-depth analysis of Rg3’s therapeutic benefits and its pharmacological actions in treating cardiac and mental health disorders respectively. Highlighting its potential for the management of these conditions, Rg3 emerges as a promising, multifunctional therapeutic agent.

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Section: The Relationships Between Heart Diseases and Mental Disordersmentioning

confidence: 99%

Section: The Relationships Between Heart Diseases and Mental Disordersmentioning

confidence: 99%

The protective role of ginsenoside Rg3 in heart diseases and mental disorders

Shi,

Luo,

Wei

et al. 2024

Front. Pharmacol.

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“…During PPGL, excessive catecholamines can lead to various cardiovascular conditions, which can sometimes be fatal, including cardiomyopathy [85]. These cardiomyopathies occurred in 11% of PPGL cases [86].…”

Section: Casementioning

confidence: 99%

Pheochromocytoma With High Adrenocorticotropic Hormone Production Capacity Without Pigmentation and Cushingoid Symptoms: A Case Report With a Literature Review

Mizutani,

Isshiki,

Shimizu

et al. 2024

Cureus

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Pheochromocytoma or paraganglioma (PPGL) originating from chromaffin cells can produce diverse hormones in addition to catecholamines, including adrenocorticotropic hormone (ACTH). In pheochromocytoma, high levels of ACTH might not result in pigmentation as typically observed in Addison's disease, and patients might not exhibit the symptoms of Cushing's syndrome, despite ACTHdependent hypercortisolism. A 63-year-old male patient with hypertension was admitted to our facility, and computed tomography (CT) revealed a large right adrenal tumor. Despite high plasma ACTH (700-1300 pg/mL) and serum cortisol (90-100 µg/dL) levels, no physical pigmentation or Cushingoid symptoms were observed. Urinary metanephrine and normetanephrine levels reached as high as 16.0 mg and 3.2 mg, respectively. 123 I-metaiodobenzylguanidine (MIBG) scintigraphy was negative. Low-dose dexamethasone paradoxically increased ACTH and cortisol levels, indicating the potential positive feedback regulation of both hormones by glucocorticoids. The patient was diagnosed with an ACTH-producing pheochromocytoma and underwent successful laparoscopic surgery to remove the adrenal tumor under the intravenous administration of a high-dose α-blocker and hydrocortisone. The levels of ACTH, cortisol, and urinary metanephrine/normetanephrine returned close to normal after tumor removal. We report a rare case of pheochromocytoma with extremely high ACTH/cortisol production but without pigmentation or Cushingoid symptoms. We also reviewed previous reports of ACTH-producing PPGL regarding the paradoxical regulation of ACTH/cortisol by glucocorticoids, pigmentation, Cushingoid symptoms, and negativity of 123 I-MIBG scintigraphy.

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Recurrent angina and cardiac ischaemia as a presentation of pheochromocytoma: a case report

van de Bovenkamp,

Kalkman,

Beijk

et al. 2024

European Heart Journal - Case Reports

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Structured abstract Introduction We present a case of a pregnant patient with recurrent angina, in which her symptoms were initially attributed to coronary artery spasm. However, during follow-up she was diagnosed as having pheochromacytoma, a rare neuroendocrine tumor. Case Presentation The 35-year old patient was admitted to the hospital because of chest pain and elevated cardiac troponins after the use of MDMA. Physical examination, ECG, echocardiography, coronary angiogram, and cardiac MRI were normal. Symptoms were attributed to coronary spasm and a calcium antagonist was started. Ten months later, when 36 weeks pregnant, her symptoms returned. One week later patient was readmitted to the hospital with signs of acute left ventricular (LV) failure, highly elevated troponins, and severe global LV dysfunction. Urgent section caesarian was performed due to maternal morbidity and fetal tachycardia. During section, flushes and marked variability in blood pressure were noted. Laboratory metanephrines testing was performed. LV function recovered within three days without any therapeutic intervention. However, chest pain reoccurred, now accompanied with headaches, malignant hypertension and accelerated idiopathic ventricular rhythms. (Nor)metanephrines tests were positive. A solid lesion in the right adrenal on CT-scan confirmed the diagnosis of pheochromocytoma. Fluid repletion and alpha-blocker therapy were started. Due to persistent symptoms, urgent laparoscopic adrenalectomy was performed. Hereafter, the patient remained without symptoms. Discussion A pheochromocytoma may present with recurrent angina and can result in a catecholamine-induced cardiomyopathy. It is important to timely recognise this diagnosis in order to minimise morbidity and mortality.

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Pheochromocytoma/paraganglioma-associated cardiomyopathy

Cited by 6 publications

References 88 publications

The protective role of ginsenoside Rg3 in heart diseases and mental disorders

The protective role of ginsenoside Rg3 in heart diseases and mental disorders

Pheochromocytoma With High Adrenocorticotropic Hormone Production Capacity Without Pigmentation and Cushingoid Symptoms: A Case Report With a Literature Review

Recurrent angina and cardiac ischaemia as a presentation of pheochromocytoma: a case report

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