Cardiovascular Disease in Cushing's Syndrome: Heart versus Vasculature
Cardiovascular Disease in Cushing's Syndrome: Heart versus Vasculature
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DOI：
10.1159/000318566
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发表时间：
2010-01-01
影响因子：
4.1
通讯作者：
Colao, Annamaria
中科院分区：
文献类型：
--
作者：
De Leo, Monica;Pivonello, Rosario;Colao, Annamaria
库欣综合征 (CS) 会导致代谢异常，从而导致心血管风险增加，不仅在疾病的活跃期，而且在治愈后的很长一段时间内也是如此。 CS 患者的心血管并发症，如过早动脉粥样硬化、冠状动脉疾病、心力衰竭和中风，导致死亡率高于正常人群。心血管风险增加主要是由于代谢并发症，如代谢综合征，但也归因于血管和心脏改变，如动脉粥样硬化以及心脏结构和功能变化。在CS患者的临床管理中，重点应放在确定总体心血管风险上，目标不仅是控制高血压，还应控制其他相关危险因素，如肥胖、葡萄糖耐受不良、胰岛素抵抗、血脂异常、内皮功能障碍和血栓前状态。考虑到皮质醇增多症的缓解通常很难实现，而且即使在疾病缓解期间心血管风险也可能持续存在，因此所有心血管危险因素的护理和控制应该是这些患者随访期间的主要目标之一。版权所有 (C) 2010 S. Karger AG，巴塞尔
Cushing's syndrome (CS) causes metabolic abnormalities that determine an increased cardiovascular risk not only during the active phase of the disease but also for a long time after cure. Cardiovascular complications, such as premature atherosclerosis, coronary artery disease, heart failure, and stroke, in patients with CS cause a mortality rate higher than that observed in a normal population. The increased cardiovascular risk is mainly due to metabolic complications, such as metabolic syndrome, but also to vascular and cardiac alterations such as atherosclerosis and cardiac structural and functional changes. In the clinical management of patients with CS the focus should be on identifying the global cardiovascular risk and the aim should be to control not only hypertension but also other correlated risk factors, such as obesity, glucose intolerance, insulin resistance, dyslipidemia, endothelial dysfunction and the prothrombotic state. Considering that remission from hypercortisolism is often difficult to achieve and that the cardiovascular risk can persist even during disease remission, care and control of all cardiovascular risk factors should be one of the primary goals during the follow-up of these patients. Copyright (C) 2010 S. Karger AG, Basel