Acute and Chronic Pheochromocytoma-Induced Cardiomyopathies: Different Prognoses? A Systematic Analytical Review
Acute and Chronic Pheochromocytoma-Induced Cardiomyopathies: Different Prognoses? A Systematic Analytical Review
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DOI：
10.1097/md.0000000000002198
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发表时间：
2015-12-01
期刊：
影响因子：
1.6
通讯作者：
Eschalier, Romain
中科院分区：
文献类型：
--
作者：
Batisse-Lignier, Marie;Pereira, Bruno;Eschalier, Romain
嗜铬细胞瘤和副神经节瘤（PPG）是罕见和晚期诊断的分泌儿茶酚胺的肿瘤，可能与未被识别和/或严重的心肌病有关。从1961年到2012年8月，我们使用MESH术语“心肌炎”、“心肌梗死”、“Takotsubo”、“应激性心肌病”、“心源性休克”或“扩张性心肌病”和“嗜铬细胞瘤”或“副神经节瘤”对电子Medline数据库进行了计算机辅助系统搜索。所有详细的PPG引起的心肌病病例报告，没有冠状动脉狭窄，并显示急性症状纳入和分析。共收集145例报告（Takotsubo型心肌病[TTC] 49例，其他儿茶酚胺型心肌病[CC] 96例）。在初次就诊时，CC和TTC的高血压患病率（87.7%）、胸痛（49.0%）、头痛（47.6%）、心悸（46.9%）、出汗（39.3%）和休克（51.0%）相似。急性肺水肿（58.3% vs 38.8%, P = 0.03）在CC患者中更为常见，两组患者在首发时出现严重左室收缩功能障碍（左室射血分数[LVEF] < 30%）的比例无差异（P = 0.15）。TTC组术前（64.9% vs 40.8%, P = 0.005）和术后（97.7% vs73.3%, P = 0.001） LVEF恢复较高。死亡11例（7.6%）。在多变量分析中，只有TTC与较好的LV恢复相关（0.15 [0.03-0.67],P = 0.03）。嗜铬细胞瘤和副神经节瘤可导致不同的心肌病，具有相同的残酷和危及生命的初始临床表现，但具有不同的恢复率。不明原因扩张型心肌病或TTC的诊断应引导临床医生特异性寻找PPG。
Pheochromocytoma and paraganglioma (PPG) are rare and late-diagnosed catecholamine secreting tumors, which may be associated with unrecognized and/or severe cardiomyopathies.We performed a computer-assisted systematic search of the electronic Medline databases using the MESH terms "myocarditis,'' "myocardial infarction,'' "Takotsubo,'' "stress cardiomyopathy,'' "cardiogenic shock'', or "dilated cardiomyopathy,'' and "pheochromocytoma'' or "paraganglioma'' from 1961 to August 2012. All detailed case reports of cardiomyopathy due to a PPG, without coronary stenosis, and revealed by acute symptoms were included and analyzed.A total of 145 cases reports were collected (49 Takotsubo Cardiomyopathies [TTC] and 96 other Catecholamine Cardiomyopathies [CC]). At initial presentation, prevalence of high blood pressure (87.7%), chest pain (49.0%), headaches (47.6%), palpitations (46.9%), sweating (39.3%), and shock (51.0%) were comparable between CC and TTC. Acute pulmonary edema (58.3% vs 38.8%, P = 0.03) was more frequent in CC. There was no difference in proportion of patients with severe left ventricular systolic dysfunction (LV Ejection Fraction [LVEF] < 30%) at initial presentation between both groups (P = 0.15). LVEF recovery before (64.9% vs 40.8%, P = 0.005) and after surgical resection (97.7% vs73.3%, P = 0.001) was higher in the TTC group. Death occurred in 11 cases (7.6%). Inmultivariate analysis, only TTC was associated with a better LV recovery (0.15 [0.03-0.67], P = 0.03).Pheochromocytoma and paraganglioma can lead to different cardiomyopathies with the same brutal and life-threatening initial clinical presentation but with a different recovery rate. Diagnosis of unexplained dilated cardiomyopathy or TTC should lead clinicians to a specific search for PPG.