This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bernini, G. Articles by Salvetti, A. Search for Related Content PubMed PubMed Citation Articles by Bernini, G. Articles by Salvetti, A. Related Collections Adrenal and Hypertension Cardiovascular Endocrinology

Carotid Vascular Remodeling in Patients with Pheochromocytoma

Department of Internal Medicine, University of Pisa, 56100 Pisa, Italy

Address all correspondence and requests for reprints to: Giampaolo Bernini, M.D., Department of Internal Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy. E-mail: g.bernini{at}med.unipi.it.

Context: The influence of catecholamines on vascular remodeling in humans was investigated.

Objective: The objective was to study the carotid vascular wall in patients with pheochromocytoma (PHEO).

Design and Setting: An observational study was conducted in a university referral center for blood pressure diseases.

Patients: Fourteen patients with PHEO, 15 matched high-normal essential hypertensives, 15 mild essential hypertensives, and 15 controls underwent two-dimensional conventional ultrasonography and ultrasonic tissue characterization of the carotid wall.

Main Outcome Measures: Intimal media thickness (IMT), diameter, and corrected ultrasonic integrated backscatter signal (C-IBS) of carotid arteries were evaluated.

Results: IMT in PHEOs (0.844 ± 0.18 mm, mean ± SD) was greater than not only controls (0.596 ± 0.09 mm, P < 0.0002) but also high-normal (0.710 ± 0.17 mm, P < 0.03), and even mild (0.727 ± 0.20 mm, P = 0.06) hypertensives. IMT in the latter was higher than in controls (P < 0.03), without difference in comparison with high-normal hypertensives. C-IBS values in PHEOs (–21.71 ± 2.0 dB, mean ± SD) were greater than in controls (–26.20 ± 1.73 dB, P < 0.0001) but also than in high-normal (–23.84 ± 1.16 dB, P < 0.002) and mild (–23.37 ± 1.99 dB, P < 0.01) hypertensives. C-IBS values in controls were lower than in high-normal (P < 0.0005) and mild (P < 0.0001) hypertensives. Carotid diameter was not significantly different in the four groups. In PHEOs, C-IBS was associated with urinary noradrenaline (r = 0.640, P < 0.01) and normethanephrine (r = 0.737, P < 0.009).

Conclusions: Carotid IMT of PHEOs is higher than in controls and matched groups of hypertensives with comparable or even higher blood pressure. This vascular rearrangement is characterized by increased IBS values due to collagen deposition and vascular fibrosis. Therefore, our data show that abnormal catecholamine levels take part per se in carotid wall remodeling of patients with PHEO.

This article has been cited by other articles:

				G. Bernini, F. Galetta, F. Franzoni, M. Bardini, C. Taurino, A. Moretti, M. Bernini, P. Berti, P. Miccoli, and A. Salvetti Normalization of catecholamine production following resection of phaeochromocytoma positively influences carotid vascular remodelling Eur. J. Endocrinol., August 1, 2008; 159(2): 137 - 143. [Abstract] [Full Text] [PDF]