ArticleThe Journal of clinical endocrinology and metabolism2021
Epicardial and Pericardial Adiposity Without Myocardial Steatosis in Cushing Syndrome.
Article in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 13 citations in OpenAlex.
- Cardiovascular effects of metyrapone treatment in patients with mild autonomous cortisol secretion: a secondary analysis.The Journal of clinical endocrinology and metabolism · 2026Article
- Review
- Adverse cardio-metabolic risk profile and epicardial adiposity in patients with adrenal adenoma: a cross-sectional study.Frontiers in endocrinology · 2026Article
- Fluctuations of epicardial adipose tissue and cardiovascular health: A useful biomarker? A comprehensive review.Journal of cardiovascular and thoracic research · 2025Review
- Mineralocorticoid axis activity and cardiac remodeling in patients with ACTH-dependent Cushing's syndrome.Endocrine connections · 2025Article
- Epicardial adipose tissue volume highly correlates with left ventricular diastolic dysfunction in endogenous Cushing's syndrome.Annals of medicine · 2024Article
- Epicardial and pericoronary adipose tissue and coronary plaque burden in patients with Cushing's syndrome: a propensity score-matched study.Journal of endocrinological investigation · 2024Article
- Cardiac magnetic resonance reveals biventricular impairment in Cushing's syndrome: a multicentre case-control study.Endocrine · 2024Article
- Cardiac disease in Cushing's syndrome. Emphasis on the role of cardiovascular magnetic resonance imaging.Endocrine · 2024Review
- Myocardial steatosis across the spectrum of human health and disease.Experimental physiology · 2024Review
- Ectopic lipid metabolism in anterior pituitary dysfunction.Frontiers in endocrinology · 2023Review
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Authors and funding
21 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextCardiovascular disease is the leading cause of death in patients with Cushing syndrome. Cortisol excess and adverse metabolic profile could increase cardiac fat, which can subsequently impair cardiac structure and function.
objectiveWe aimed to evaluate cardiac fat mass and distribution in patients with Cushing syndrome.
methodsIn this prospective, cross-sectional study, 23 patients with Cushing syndrome and 27 control individuals of comparable age, sex, and body mass index were investigated by cardiac magnetic resonance imaging and proton spectroscopy. Patients were explored before and after biochemical disease remission. Myocardial fat measured by the Dixon method was the main outcome measure. The intramyocardial triglyceride/water ratio measured by spectroscopy and epicardial and pericardial fat volumes were secondary outcome measures.
resultsNo difference was found between patients and controls in intramyocardial lipid content. Epicardial fat mass was increased in patients compared to controls (30.8 g/m2 [20.4-34.8] vs 17.2 g/m2 [13.1-23.5], P < .001). Similarly, pericardial fat mass was increased in patients compared to controls (28.3 g/m2 [17.9-38.0] vs 11.4 g/m2 [7.5-19.4], P = .003). Sex, glycated hemoglobin A1c, and the presence of hypercortisolism were independent determinants of epicardial fat. Pericardial fat was associated with sex, impaired glucose homeostasis and left ventricular wall thickness. Disease remission decreased epicardial fat mass without affecting pericardial fat.
conclusionIntramyocardial fat stores are not increased in patients with Cushing syndrome, despite highly prevalent metabolic syndrome, suggesting increased cortisol-mediated lipid consumption. Cushing syndrome is associated with marked accumulation of epicardial and pericardial fat. Epicardial adiposity may exert paracrine proinflammatory effects promoting cardiomyopathy.
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