Echocardiographic alterations in patients with non-functioning adrenal incidentaloma

Objective: While left ventricular (LV) dysfunction has been described in patients with Cushing's syndrome (CS), data concerning morphologic and functional cardiac alterations in patients with incidentally discovered adrenal masses [adrenal "incidentaloma" (Al)], without overt hypercortisolism, are lacking. In this study the echocardiographic characteristics of patients with Al were evaluated and then compared with those of lean and obese normotensive subjects. Subjects and methods: Twenty-one patients with All, without clinical or subclinical hypercortisolism, 18 normotensive obese subjects matched for gender and body mass index (BMI) and 20 normotensive lean subjects were studied. Echocardiography was performed in all subjects. In all patients plasma ACTH, serum cortisol, and DHEA-S levels were measured. Results: Patients with Al showed greater impairment of several echocardiographic indices of LV hypertrophy and diastolic dysfunction compared to normotensive lean subjects (p < 0.05), but did not differ from those in obese subjects. Hypertensive Al patients showed a greater alteration of echocardiographic parameters (p < 0.05) and higher BMI (p < 0.01) and cortisol values (p < 0.05) than normotensive ones. Plasma ACTH and serum cortisol were similar in Al patients and in obese controls, while DHEA-S levels were lower in Al (p < 0.05). No correlations between cortisol secretion and echocardiographic parameters were found. Conclusion: In patients with non-functioning Al there is an impairment of cardiac morphology and function. These data suggest that patients with Al should be carefully screened also by means of echocardiographic studies.