Catecholamineinduced cardiomyopathy in patients with pheochromocytoma

Abstract

The article discusses the reasons of specific cardiomyopathy in patients with pheochromocytoma and post operation lungs oedema. 106 pheochromocytoma patients were operated between 2004 and 2012 in Endocrine Research Center, 19 of them were investigated for ischemia myocardial changes. This cohort is divided into 2 groups: the first one includes 13 patients with preoperation notes of acute myocardial infarc tion (non Q developing), the second one consists of 6 patients with lung oedema in early postoperation time. All patients were operated after adequate preparation with α and βblockers. After clinical examina tion only 1 patient had conclusive ischemia, which required correction. Among reasons influencing a lung oedema (tumour size, manipulation time, age, sex, fluctuations of blood pressure) only the epinephrine type of tumor secretion was significant. Conclusion. Patients with adrenaline type secretion of pheochromocytoma have a higher risk of a lung oedema. The level of risk doesn’t depend on myocardial ischemia. Discussion. Possibility and necessity of administration of tyrozinkynase inhibitor (αmetylparatyrozine) or sensitisers of myocardial contraction (levosemindan) as the main means for preparation to a pheochromo cytoma surgery in epinephrinetype patients must be considered.

Keywords

• pheochromocytoma
• hypertension
• adrenal tumor
• cardiomyopathy