{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:44:41Z","timestamp":1790811881876,"version":"4.1.0"},"reference-count":29,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Chronic glucocorticoids excess leads to morphological and functional cardiac alterations, a substrate for arrhythmias. Autonomous cortisol secretion (ACS) in adrenal incidentalomas is a model of chronic endogenous hypercortisolism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To investigate prevalence and incidence of atrial fibrillation (AF) in a large cohort of patients with ACS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>University hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>Patients evaluated between 1990 and 2018 for adrenal incidentalomas (n\u2005=\u2005632), without pheochromocytoma, primary aldosteronism, Cushing syndrome, congenital adrenal hyperplasia, and adrenal malignancy. Cortisol after 1-mg dexamethasone suppression test\u2005&amp;lt;\u2005or\u2005&amp;gt;\u200550 nmol\/L defined nonsecreting tumors (NST) (n\u2005=\u2005420) and ACS (n\u2005=\u2005212), respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention<\/jats:title>\n                  <jats:p>Assessment of AF at baseline (n\u2005=\u2005632) and during a median follow-up of 7.7 years retrospectively (NST, n\u2005=\u2005249; ACS, n\u2005=\u2005108). Comparison with general population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure<\/jats:title>\n                  <jats:p>Prevalence and incidence of AF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>AF prevalence was higher in patients with ACS (8.5%) than NST (3.1%, P\u2005=\u20050.003) and the general population (1.7%; P\u2005&amp;lt;\u20050.001 vs ACS, P\u2005=\u20050.034 vs NST). The age-adjusted rate ratio to the general population was 1.0 for NST and 2.6 for ACS. AF was associated with ACS (odds ratio, 2.40; 95% confidence interval [CI], 1.07-5.39; P\u2005=\u20050.035). The proportion of patients with AF at last evaluation was higher in ACS (20.0%) than NST (11.9%; P\u2005=\u20050.026). ACS showed a higher risk of incident AF than NST (hazard ratio, 2.95; 95% CI, 1.27-6.86; P\u2005=\u20050.012), which was associated with post-dexamethasone cortisol (hazard ratio, 1.15; 95% CI, 1.07-1.24; P\u2005&amp;lt;\u20050.001), independently of known contributing factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with adrenal incidentalomas and ACS are at risk of AF. Electrocardiogram monitoring may be recommended during follow-up.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa270","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T13:55:07Z","timestamp":1591797307000},"page":"e2770-e2777","source":"Crossref","is-referenced-by-count":34,"title":["Prevalence and Incidence of Atrial Fibrillation in a Large Cohort of Adrenal Incidentalomas: A Long-Term Study"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1291-8906","authenticated-orcid":false,"given":"Guido","family":"Di Dalmazi","sequence":"first","affiliation":[{"name":"Endocrinology and Diabetes Prevention and Care Unit, Department of Medical and Surgical Sciences, University Alma Mater Studiorum of Bologna, S. 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