{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:00:24Z","timestamp":1790787624384,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"SGPGI Intramural fund","award":["2018-185-Mch-EXP-4"],"award-info":[{"award-number":["2018-185-Mch-EXP-4"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pheochromocytoma and paraganglioma (PPGL) are catecholamine producing tumors of chromaffin cell origin, known to cause varied cardiovascular manifestations from hypertension to myocardial infarction. This study sought to objectively evaluate the cardiac changes in PPGL patients and their reversal following curative surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PheoCard study was registered in ClinicalTrials.gov (NCT05082311) and involved 35 consecutive PPGL patients managed as per standard protocol involving alpha blockade followed by curative surgery. They underwent detailed cardiac evaluation using 2D\u2010echocardiography and speckle tracking echocardiography at the time of diagnosis, 7\u201310\u00a0days after alpha blockade, and at 7\u00a0days, 3\u00a0months, and 6\u00a0months after surgical removal. Age\u2010 and gender\u2010matched essential hypertensives and healthy individuals (10\u00a0in each group) served as two control groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with PPGLs had significantly higher mean blood pressure, left ventricle end\u2010diastolic dimension and volume (LVEDD, LVEDV), left ventricle end\u2010systolic volume (LVESV), septal wall thickness, LV hypertrophy, lower mean LV ejection fraction (LVEF), early diastolic mitral annular velocity (E\/A), decreased amplitude of LV longitudinal strain, and increased circumferential strain (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) when compared with the control groups at baseline. After alpha blockade, there was marked reduction in the mean LVEDD, LVEDV, LVESV, and normalization of E\/A ratio (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) in the PPGL patients. Following curative surgery (normalization of fractionated urinary metanephrines at 7\u201310\u00a0days post\u2010operatively), there was early improvement in all echocardiographic parameters and it continued to improve even at 6\u00a0months after surgery. There was marked improvement in the global longitudinal strain as seen on serial speckle tracking echocardiography with recovery of most of the segments of LV depicting the reversal of subclinical endocardial dysfunction (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PPGL patients despite normal systolic function have subclinical LV diastolic dysfunction which is reversed after curative surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>ClinicalTrials.gov NCT05082311.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06731-6","type":"journal-article","created":{"date-parts":[[2022,10,9]],"date-time":"2022-10-09T23:03:41Z","timestamp":1665356621000},"page":"304-311","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cardiac Changes and Their Reversal Following Curative Surgery in Pheochromocytoma: PheoCard Prospective Cohort Study"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9599-6626","authenticated-orcid":false,"given":"K. 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M.","family":"Vishvak Chanthar","sequence":"first","affiliation":[{"name":"Department of Endocrine &amp; Breast Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences Raebareli Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopali","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sanjay Gandhi Postgraduate Institute of Medical Sciences Raebareli Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Endocrine &amp; Breast Surgery Sanjay Gandhi Postgraduate Institute of Medical Sciences Raebareli Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smarak Ranjan","family":"Rout","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sanjay Gandhi Postgraduate Institute of Medical Sciences Raebareli Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sanjay Gandhi Postgraduate Institute of Medical Sciences Raebareli Road 226014 Lucknow Uttar Pradesh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sabaretnam","sequence":"additional","affiliation":[{"name":"Department of Endocrine &amp; 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