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The mechanisms for this is unclear.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>To assess CV structure and function in AI patients on conventional replacement therapy and after switching to once-daily, modified-release hydrocortisone (OD-HC) in comparison with healthy matched controls.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a retrospective analysis of 17 adult AI patients (11 with primary AI, 6 with secondary AI) on stable replacement with cortisone acetate [median (minimum, maximum) 33.5 (12.5\u201350)\u2009mg] and, if needed, fludrocortisone [0.1 (0.05\u20130.2)\u2009mg], and 17 healthy matched controls. Ten patients were switched to an equivalent dose of OD-HC. Data from echocardiography, 24\u2009h Holter-ECG and 24\u2009h blood pressure monitoring were collected at baseline and 6 months after the switch to OD-HC.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>At baseline, AI patients had smaller left ventricular diastolic diameter (47.1\u2009\u00b1\u20094.2 vs. 51.6\u2009\u00b1\u20092.3\u2009mm; <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and left atrial diameter (34.9\u2009\u00b1\u20094.7 vs. 38.2\u2009\u00b1\u20092.6\u2009cm; <jats:italic>P<\/jats:italic>\u2009=\u20090.018), and a higher ejection fraction (62.5\u2009\u00b1\u20096.9% vs. 56.0\u2009\u00b1\u20094.7%; <jats:italic>P<\/jats:italic>\u2009=\u20090.003) than controls. AI patients had lower nocturnal systolic and diastolic blood pressure than controls (108\u2009\u00b1\u200915\u2009mmHg vs. 117\u2009\u00b1\u20098\u2009mmHg; <jats:italic>P<\/jats:italic>\u2009=\u20090.038 and 65\u2009\u00b1\u20099\u2009mmHg vs. 73\u2009\u00b1\u20097\u2009mmHg; <jats:italic>P<\/jats:italic>\u2009=\u20090.008, respectively). After the switch to OD-HC, nocturnal diastolic blood pressure normalised. No significant changes were observed in echocardiographic and Holter-ECG parameters following the switch.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>AI patients on conventional treatment display cardiovascular abnormalities that could be related to hypovolemia. Switch to OD-HC seems to have beneficial effect on blood pressure profile, but no effect on cardiovascular structure and function.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s12020-020-02458-3","type":"journal-article","created":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T06:02:55Z","timestamp":1597816975000},"page":"412-420","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Patients with adrenal insufficiency have cardiovascular features associated with hypovolemia"],"prefix":"10.1007","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-2071","authenticated-orcid":false,"given":"Daniela","family":"Esposito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Bobbio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Di Fraia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Mone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Accardo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"De Bellis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Iorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Marfella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudmundur","family":"Johannsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Ragnarsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Pasquali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,19]]},"reference":[{"issue":"9935","key":"2458_CR1","doi-asserted-by":"publisher","first-page":"2152","DOI":"10.1016\/S0140-6736(13)61684-0","volume":"383","author":"E Charmandari","year":"2014","unstructured":"E. 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