Evidence map›Paper›PMID 40119309›Full record

ArticleCardiovascular diabetology2025

The impact of hypercortisolism beyond metabolic syndrome on left ventricular performance: a myocardial work analysis.

Floran Sahiti, Mario Detomas, Vladimir Cejka, Kristina Hoffmann, Götz Gelbrich, Stefan Frantz, Mathias Kroiss, Peter U Heuschmann, Stefanie Hahner, Martin Fassnacht and 3 more

Abstract readComparative Study
In one paragraph

Article in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Floran SahitiDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Mario DetomasDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
Vladimir CejkaDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Kristina HoffmannDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
Götz GelbrichDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Stefan FrantzDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Mathias KroissDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
Peter U HeuschmannDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Stefanie HahnerDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
Martin FassnachtDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
Timo DeutschbeinDivision of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
Stefan StörkDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany.
Caroline MorbachDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany. Morbach_C@ukw.de.

Funding

German Ministry for Education and Research 01EO1004German Ministry for Education and Research 01EO1504
6 · The paper itself

Abstract

BACKGROUND AND

aimsEndogenous Cushing's syndrome (CS) is characterized by an unfavorable cardiovascular (CV) and metabolic risk profile, but the potential adverse effects of hypercortisolism on myocardial function are not well known. Myocardial Work analysis is a new echocardiographic method that utilizes left ventricular pressure-strain loops to quantify cardiac performance independent of afterload. METHODS AND

resultsIn a cross-sectional analysis, we compared four groups: patients with overt endogenous CS (n = 31, mean age 47 ± 12 years, 71% women), patients with endogenous CS in long-term remission after medical cure (CS-LTR; n = 49, 53 ± 12 years, 78% women), healthy subjects (n = 439; 49 ± 11 years, 57% women), and individuals with metabolic syndrome (n = 305, 59 ± 10 years, 37% women). Both CS patient groups exhibited a CV risk pattern and metabolic profile worse than healthy subjects but better than individuals with metabolic syndrome. Analyses adjusted for sex and age revealed higher Wasted Work both in overt CS (median; quartiles: 105 mmHg%; 74, 147) and CS-LTR (97 mmHg%; 69, 158), respectively, when compared to healthy individuals (75 mmHg%; 54, 109, p < 0.01) or individuals with metabolic syndrome (95 mmHg%, 65, 136, p < 0.05), resulting in compromised Work Efficiency (p < 0.05).

conclusionLeft ventricular performance is compromised in overt CS beyond alterations found in individuals with metabolic syndrome sharing equal CV risk factors and remains so despite biochemical remission during the LTR period. Myocardial Work analysis is suited to detect the subtle yet clinically relevant differences between different phenotypes of myocardial involvement.

Indexed as

Cushing SyndromeMetabolic SyndromeMyocardial ContractionVentricular Dysfunction, LeftVentricular Function, LeftAdultAgedCase-Control StudiesCross-Sectional StudiesFemaleHumansMaleMiddle AgedPredictive Value of TestsRisk FactorsCortisolCushing's syndromeLeft ventricular performanceMetabolic syndromeMyocardial work

Identifiers

PMID40119309
PMCPMC11929293

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.