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Myocardial Work analysis is a new echocardiographic method that utilizes left ventricular pressure-strain loops to quantify cardiac performance independent of afterload.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and results<\/jats:title>\n            <jats:p>In a cross-sectional analysis, we compared four groups: patients with overt endogenous CS (n\u2009=\u200931, mean age 47\u2009\u00b1\u200912 years, 71% women), patients with endogenous CS in long-term remission after medical cure (CS-LTR; n\u2009=\u200949, 53\u2009\u00b1\u200912 years, 78% women), healthy subjects (n\u2009=\u2009439; 49\u2009\u00b1\u200911 years, 57% women), and individuals with metabolic syndrome (n\u2009=\u2009305, 59\u2009\u00b1\u200910 years, 37% women). Both CS patient groups exhibited a CV risk pattern and metabolic profile worse than healthy subjects but better than individuals with metabolic syndrome. Analyses adjusted for sex and age revealed higher Wasted Work both in overt CS (median; quartiles: 105 mmHg%; 74, 147) and CS-LTR (97 mmHg%; 69, 158), respectively, when compared to healthy individuals (75 mmHg%; 54, 109, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) or individuals with metabolic syndrome (95 mmHg%, 65, 136, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), resulting in compromised Work Efficiency (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Left ventricular performance is compromised in overt CS beyond alterations found in individuals with metabolic syndrome sharing equal CV risk factors and remains so despite biochemical remission during the LTR period. Myocardial Work analysis is suited to detect the subtle yet clinically relevant differences between different phenotypes of myocardial involvement.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12933-025-02680-1","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T20:19:15Z","timestamp":1742588355000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of hypercortisolism beyond metabolic syndrome on left ventricular performance: a myocardial work analysis"],"prefix":"10.1186","volume":"24","author":[{"given":"Floran","family":"Sahiti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Detomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Cejka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6tz","family":"Gelbrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Frantz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Kroiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter U.","family":"Heuschmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hahner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Deutschbein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"St\u00f6rk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Morbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"issue":"5","key":"2680_CR1","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1210\/jc.2008-0125","volume":"93","author":"LK Nieman","year":"2008","unstructured":"Nieman LK, Biller BM, Findling JW, Newell-Price J, Savage MO, Stewart PM, et al. 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