Dynamics of NT-proBNP and ST2 levels as markers of heart failure in patients with endogenous Cushing syndrome (hypercortisolism)

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Abstract

Aim. To evaluate frequency of heart failure syndrome in patients with endogenous hypercortisolism and to establish relationship between effective treatment for hypercortisolism and regression of heart failure with particular emphasis on the observation of NT-proBNP and ST2 levels.

Materials and methods. 56 patients with endogenous hypercortisolism (45 female, mean age 47 years [36; 55] hospitalized with endogenous hypercortisolism to National Medical Research Center for Endocrinology were enrolled in the study. All patients underwent comprehensive clinical investigation including expert echocardiography with speckle tracking and evaluation of NT-proBNP and ST2 cardiac biomarkers at baseline and 6 months after surgical treatment.

Results. According to clinical data and elevated biomarkers of cardiac stress 28 out of 56 patients (50%) at baseline met the criteria for heart failure. 20 patients were included in the final analysis. Follow-up investigation with focus on changes in NT-proBNP and ST2 levels demonstrated that surgical correction of endogenous hypercortisolism resulted in resolution of heart failure syndrome in 11 patients (55%).

Conclusion. These preliminary data suggest that signs and symptoms of heart failure are observed in patients with endogenous hypercortisolism in about half the cases. Surgical correction results in resolution of heart failure in approximately two thirds of the cases. Prospective evaluation NT-proBNP and ST2 levels may provide important diagnostic and prognostic information in patients with endogenous hypercortisolism.

About the authors

Raisa S. Kosharnaia

National Medical Research Center for Endocrinology

Author for correspondence.
Email: kosharnaya.raisa@mail.ru
ORCID iD: 0000-0003-1387-683X
SPIN-code: 9349-6790

врач-кардиолог отд-ния кардиологии, эндоваскулярной и сосудистой хирургии

Russian Federation, Moscow

Zhanna E. Belaya

National Medical Research Center for Endocrinology

Email: kosharnaya.raisa@mail.ru
ORCID iD: 0000-0002-6674-6441

д-р мед. наук, гл. науч. сотр., зав. отд-нием нейроэндокринологии и остеопатий

Russian Federation, Moscow

Zamira T. Zuraeva

National Medical Research Center for Endocrinology

Email: kosharnaya.raisa@mail.ru
ORCID iD: 0000-0001-6953-6928

канд. мед. наук, эндокринолог, сотр. клинико-диагностической лаборатории

Russian Federation, Moscow

Marina S. Michurova

National Medical Research Center for Endocrinology

Email: kosharnaya.raisa@mail.ru
ORCID iD: 0000-0003-1495-5847

науч. сотр. отд-ния кардиологии, эндоваскулярной и сосудистой хирургии

Russian Federation, Moscow

Victor Y. Kalashnikov

National Medical Research Center for Endocrinology

Email: kosharnaya.raisa@mail.ru
ORCID iD: 0000-0001-5573-0754

чл.-кор. РАН, д-р мед. наук, проф., зав. отд. кардиологии и сосудистой хирургии

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Correlation between growth factor level expressed by genome 2, ng/ml, and free cortisol level in saliva at 23:00, nmol/l.

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3. Fig. 2. Correlation between the level of the N-terminal fragment of the cerebral sodium peptide, pg/ml, and the level of free cortisol in saliva at 23:00, nmol/l.

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4. Fig. 3. Correlation between the level of growth factor expressed by genome 2, ng/ml, and potassium, mmol/l.

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5. Fig. 4. Correlation between the level of the N-terminal fragment of the cerebral sodium peptide, pg/ml, and potassium, mmol/l.

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