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      Endocrine causes of heart failure: A clinical primer for cardiologists

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          Abstract

          Heart failure (HF) may be a presenting manifestation of a few endocrine disorders and should be considered in evaluation of heart failure causes. This clinically oriented review is an attempt to highlight the protean manifestations of heart failure in endocrine diseases which could present either as acute or chronic heart failure. Acute heart failure manifests as hypertensive crisis, Takotsubo syndrome, or as tachy/brady cardiomyopathies. Chronic heart failure could masquerade with features of hyperdynamic heart failure, or hypertrophic, restrictive or dilated cardiomyopathy. Rarely constrictive features or resistant heart failure could be the presenting feature. Isolated presentation as pulmonary hypertension and right heart failure are also documented. Good history-taking and physical examination with targeted investigations will help in the timely management for reversing the pathophysiology to a significant extent by appropriated management.

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          The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.

          John Funder, Robert Carey, Franco Mantero … (2016)
          To develop clinical practice guidelines for the management of patients with primary aldosteronism.
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            Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline.

            Jacques Lenders, Quan-Yang Duh, Graeme Eisenhofer … (2014)
            The aim was to formulate clinical practice guidelines for pheochromocytoma and paraganglioma (PPGL).
            Article 0 comments Cited 471 times – based on 0 reviews     Review now
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              A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients.

              Gian Paolo Rossi, Giampaolo Bernini, Chiara Caliumi … (2006)
              We prospectively investigated the prevalence of curable forms of primary aldosteronism (PA) in newly diagnosed hypertensive patients. The prevalence of curable forms of PA is currently unknown, although retrospective data suggest that it is not as low as commonly perceived. Consecutive hypertensive patients referred to 14 hypertension centers underwent a diagnostic protocol composed of measurement of Na+ and K+ in serum and 24-h urine, sitting plasma renin activity, and aldosterone at baseline and after 50 mg captopril. The patients with an aldosterone/renin ratio >40 at baseline, and/or >30 after captopril, and/or a probability of PA (by a logistic discriminant function) > or =50% underwent imaging tests and adrenal vein sampling (AVS) or adrenocortical scintigraphy to identify the underlying adrenal pathology. An aldosterone-producing adenoma (APA) was diagnosed in patients who in addition to excess autonomous aldosterone secretion showed: 1) lateralized aldosterone secretion at AVS or adrenocortical scintigraphy, 2) adenoma at surgery and pathology, and 3) a blood pressure decrease after adrenalectomy. Evidence of excess autonomous aldosterone secretion without such criteria led to a diagnosis of idiopathic hyperaldosteronism (IHA). A total of 1,180 patients (age 46 +/- 12 years) were enrolled; a conclusive diagnosis was attained in 1,125 (95.3%). Of these, 54 (4.8%) had an APA and 72 (6.4%) had an IHA. There were more APA (62.5%) and fewer IHA cases (37.5%) at centers where AVS was available (p = 0.002); the opposite occurred where AVS was unavailable. In newly diagnosed hypertensive patients referred to hypertension centers, the prevalence of APA is high (4.8%). The availability of AVS is essential for an accurate identification of the adrenocortical pathologies underlying PA.
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                Author and article information

                Contributors
                Hiya Boro
                Journal
                Journal ID (nlm-ta): Indian Heart J
                Journal ID (iso-abbrev): Indian Heart J
                Title: Indian Heart Journal
                Publisher: Elsevier
                ISSN (Print): 0019-4832
                ISSN (Electronic): 2213-3763
                Publication date (Print): Jan-Feb 2021
                Publication date (Electronic): 11 November 2020
                Volume: 73
                Issue: 1
                Pages: 14-21
                Affiliations
                [a ]Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
                [b ]Department of Cardiology, Holy Heart Advanced Cardiac Care and Research Centre, Rohtak, 124001, Haryana, India
                Author notes
                [∗ ]Corresponding author. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, 110029, India. hiya21288@ 123456gmail.com
                Article
                Publisher Item ID: S0019-4832(20)30269-8
                DOI: 10.1016/j.ihj.2020.11.003
                PMC ID: 7961238
                PubMed ID: 33714404
                SO-VID: d1d3b0fe-ace8-4333-b30e-9f012299f080
                Copyright © © 2020 Cardiological Society of India. Published by Elsevier B.V.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 2 May 2020
                Date accepted : 3 November 2020
                Categories
                Subject: Review Article

                Keywords: heart failure,endocrine causes,pheochromocytoma,acromegaly,hyperaldosteronism
                Data availability:
                Keywords: heart failure, endocrine causes, pheochromocytoma, acromegaly, hyperaldosteronism

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