{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:53:12Z","timestamp":1788447192356,"version":"build-2803163510"},"reference-count":39,"publisher":"The Endocrine Society","issue":"11","funder":[{"DOI":"10.13039\/501100003243","name":"Ministerstvo Zdravotnictv\u00ed Cesk\u00e9 Republiky","doi-asserted-by":"publisher","award":["16-30345A"],"award-info":[{"award-number":["16-30345A"]}],"id":[{"id":"10.13039\/501100003243","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007397","name":"Univerzita Karlova v Praze","doi-asserted-by":"publisher","award":["PROGRES Q25"],"award-info":[{"award-number":["PROGRES Q25"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007397","name":"Univerzita Karlova v Praze","doi-asserted-by":"publisher","award":["PROGRES Q28"],"award-info":[{"award-number":["PROGRES Q28"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Impaired diurnal blood pressure (BP) variability is related to higher cardiovascular risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess diurnal variability of BP and its relation to target organ damage (TOD) and catecholamine phenotype in a consecutive sample of pheochromocytoma\/paraganglioma (PPGL).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>We included 179 patients with PPGL All patients underwent 24 hours of ambulatory BP monitoring to determine dipping status. Differences in plasma metanephrine or urine adrenaline were used to distinguish catecholamine biochemical phenotype. To evaluate TOD, renal functions, presence of left ventricle hypertrophy (LVH), and the subgroup (n = 111) carotid-femoral pulse wave velocity (PWV) were assessed. Structural equation modeling was used to find the relationship among nocturnal dipping, catecholamine phenotype, and TOD parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>According to the nocturnal dipping, patients were divided into the three groups: dippers (28%), nondippers (40%), and reverse dippers (32%). Reverse dippers were older (P &lt; 0.05), with a higher proportion of noradrenergic (NA) phenotype (P &lt; 0.05), a higher prevalence of diabetes mellitus (P &lt; 0.05), and sustained arterial hypertension (P &lt; 0.01) and its duration (P &lt; 0.05), as opposed to the other groups. All parameters of TOD were more pronounced only in reverse dippers compared with nondippers and dippers. The presence of NA phenotype (=absence of adrenaline production) was associated with reverse dipping and TOD (LVH and PWV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with reverse dipping had more substantial TOD compared with other groups. The NA phenotype plays an important role, not only in impaired diurnal BP variability but also independently from dipping status in more pronounced TOD of heart and vessels.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2018-02644","type":"journal-article","created":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T09:03:08Z","timestamp":1555923788000},"page":"5170-5180","source":"Crossref","is-referenced-by-count":33,"title":["Blood Pressure Profile, Catecholamine Phenotype, and Target Organ Damage in Pheochromocytoma\/Paraganglioma"],"prefix":"10.1210","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8992-3562","authenticated-orcid":false,"given":"Ond\u0159ej","family":"Petr\u00e1k","sequence":"first","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-7751","authenticated-orcid":false,"given":"J\u00e1n","family":"Rosa","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9488-9706","authenticated-orcid":false,"given":"Robert","family":"Holaj","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5137-7017","authenticated-orcid":false,"given":"Branislav","family":"\u0160trauch","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5107-2926","authenticated-orcid":false,"given":"Zuzana","family":"Kr\u00e1tk\u00e1","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kvasni\u010dka","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judita","family":"Kl\u00edmov\u00e1","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4668-5837","authenticated-orcid":false,"given":"Petr","family":"Waldauf","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Hospital Kr\u00e1lovsk\u00e9 Vinohrady and Third Faculty of Medicine, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbora","family":"Hamplov\u00e1","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Markvartov\u00e1","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kv\u011btoslav","family":"Nov\u00e1k","sequence":"additional","affiliation":[{"name":"Department of Urology, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Michalsk\u00fd","sequence":"additional","affiliation":[{"name":"First Department of Surgery, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Ji\u0159\u00ed","family":"Widimsk\u00fd","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1\u0161","family":"Zelinka","sequence":"additional","affiliation":[{"name":"Center of Hypertension, Third Department of Medicine, First Faculty of Medicine and General Faculty Hospital, Charles University in Prague, Prague 2, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2019,4,22]]},"reference":[{"issue":"2","key":"2019092505514020500_bib1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.3803\/EnM.2017.32.2.152","article-title":"Update on modern management of pheochromocytoma and paraganglioma","volume":"32","author":"Lenders","year":"2017","journal-title":"Endocrinol Metab (Seoul)"},{"issue":"2","key":"2019092505514020500_bib2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1080\/10253890701395896","article-title":"Pheochromocytoma as a catecholamine producing tumor: implications for clinical practice","volume":"10","author":"Zelinka","year":"2007","journal-title":"Stress"},{"issue":"2","key":"2019092505514020500_bib3","doi-asserted-by":"crossref","first-page":"65","DOI":"10.4149\/endo_2011_02_65","article-title":"Phaeochromocytoma: a catecholamine and oxidative stress disorder","volume":"45","author":"Pacak","year":"2011","journal-title":"Endocr Regul"},{"issue":"5","key":"2019092505514020500_bib4","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1055\/s-0032-1306294","article-title":"High incidence of cardiovascular complications in pheochromocytoma","volume":"44","author":"Zelinka","year":"2012","journal-title":"Horm Metab Res"},{"issue":"20","key":"2019092505514020500_bib5","doi-asserted-by":"crossref","first-page":"2364","DOI":"10.1016\/j.jacc.2016.03.543","article-title":"Pheochromocytoma is characterized by catecholamine-mediated myocarditis, focal and diffuse myocardial fibrosis, and myocardial dysfunction","volume":"67","author":"Ferreira","year":"2016","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"2019092505514020500_bib6","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1196\/annals.1353.009","article-title":"Characteristics of blood pressure in pheochromocytoma","volume":"1073","author":"Zelinka","year":"2006","journal-title":"Ann N Y Acad Sci"},{"issue":"2","key":"2019092505514020500_bib7","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1038\/sj.jhh.1001644","article-title":"Diurnal blood pressure variation in pheochromocytoma, primary aldosteronism and Cushing\u2019s syndrome","volume":"18","author":"Zelinka","year":"2004","journal-title":"J Hum Hypertens"},{"issue":"7","key":"2019092505514020500_bib8","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1111\/jch.13023","article-title":"Clinical and prognostic significance of a reverse dipping pattern on ambulatory monitoring: an updated review","volume":"19","author":"Cuspidi","year":"2017","journal-title":"J Clin Hypertens (Greenwich)"},{"issue":"5","key":"2019092505514020500_bib9","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1210\/jc.2005-2199","article-title":"Carotid vascular remodeling in patients with pheochromocytoma","volume":"91","author":"Bernini","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2019092505514020500_bib10","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1038\/jhh.2008.130","article-title":"Increased carotid intima-media thickness in patients with pheochromocytoma in comparison to essential hypertension","volume":"23","author":"Holaj","year":"2009","journal-title":"J Hum Hypertens"},{"issue":"5","key":"2019092505514020500_bib11","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1038\/hr.2010.12","article-title":"Factors influencing arterial stiffness in pheochromocytoma and effect of adrenalectomy","volume":"33","author":"Petr\u00e1k","year":"2010","journal-title":"Hypertens Res"},{"issue":"4","key":"2019092505514020500_bib12","first-page":"1208","article-title":"Long-term effect of adrenalectomy on cardiovascular remodeling in patients with pheochromocytoma","volume":"102","author":"Majtan","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2019092505514020500_bib13","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/echo.13752","article-title":"Subclinical left ventricular systolic dysfunction detected by two-dimensional speckle tracking echocardiography in patients with pheochromocytoma and paraganglioma and preserved ejection fraction","volume":"35","author":"Ding","year":"2018","journal-title":"Echocardiography"},{"issue":"4","key":"2019092505514020500_bib14","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1373\/clinchem.2004.045484","article-title":"Pheochromocytoma catecholamine phenotypes and prediction of tumor size and location by use of plasma free metanephrines","volume":"51","author":"Eisenhofer","year":"2005","journal-title":"Clin Chem"},{"issue":"2","key":"2019092505514020500_bib15","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1210\/jc.2010-1588","article-title":"Age at diagnosis of pheochromocytoma differs according to catecholamine phenotype and tumor location","volume":"96","author":"Eisenhofer","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2019092505514020500_bib16","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"issue":"2","key":"2019092505514020500_bib17","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1161\/HYPERTENSIONAHA.115.06526","article-title":"Role of adding spironolactone and renal denervation in true resistant hypertension: one-year outcomes of randomized PRAGUE-15 Study","volume":"67","author":"Rosa","year":"2016","journal-title":"Hypertension"},{"issue":"3","key":"2019092505514020500_bib18","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1097\/HJH.0b013e32834fa8b0","article-title":"Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity","volume":"30","author":"Van Bortel","year":"2012","journal-title":"J Hypertens"},{"issue":"3","key":"2019092505514020500_bib19","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"4","key":"2019092505514020500_bib20","first-page":"397","article-title":"Effect of removal of phaeochromocytoma on diurnal variability of blood pressure, heart rhythm and excretion of catecholamines","volume":"4","author":"Dabrowska","year":"1990","journal-title":"J Hum Hypertens"},{"issue":"6","key":"2019092505514020500_bib21","first-page":"501","article-title":"Reversal of the relationship between heart rate and blood pressure in phaeochromocytoma: a non-invasive diagnostic approach","volume":"5","author":"Padfield","year":"1991","journal-title":"J Hum Hypertens"},{"issue":"6929","key":"2019092505514020500_bib22","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1136\/bmj.308.6929.630","article-title":"Nocturnal blood pressure in normotensive subjects and those with white coat, primary, and secondary hypertension","volume":"308","author":"Middeke","year":"1994","journal-title":"BMJ"},{"issue":"3","key":"2019092505514020500_bib23","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/00004872-199403000-00008","article-title":"Spectral analysis of the systolic blood pressure signal in secondary hypertension: a method for the identification of phaeochromocytoma","volume":"12","author":"Meisel","year":"1994","journal-title":"J Hypertens"},{"issue":"11","key":"2019092505514020500_bib24","doi-asserted-by":"crossref","first-page":"2033","DOI":"10.1097\/01.hjh.0000185714.60788.52","article-title":"Increased blood pressure variability in pheochromocytoma compared to essential hypertension patients","volume":"23","author":"Zelinka","year":"2005","journal-title":"J Hypertens"},{"issue":"1","key":"2019092505514020500_bib25","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/00004872-198801000-00003","article-title":"Hypertensive episodes and circadian fluctuations of blood pressure in patients with phaeochromocytoma: studies by long-term blood pressure monitoring based on a volume-oscillometric method","volume":"6","author":"Imai","year":"1988","journal-title":"J Hypertens"},{"issue":"6","key":"2019092505514020500_bib26","first-page":"492","article-title":"Diurnal variation of blood pressure in patients with catecholamine-producing tumors","volume":"7","author":"van Eps","year":"1994","journal-title":"Am J Hypertens"},{"issue":"1","key":"2019092505514020500_bib27","doi-asserted-by":"crossref","first-page":"25053","DOI":"10.1038\/srep25053","article-title":"Relationship between blood pressure reverse dipping and type 2 diabetes in hypertensive patients","volume":"6","author":"Sun","year":"2016","journal-title":"Sci Rep"},{"issue":"5","key":"2019092505514020500_bib28","doi-asserted-by":"crossref","first-page":"E1223","DOI":"10.1152\/ajpendo.90591.2008","article-title":"Differential expression of the regulated catecholamine secretory pathway in different hereditary forms of pheochromocytoma","volume":"295","author":"Eisenhofer","year":"2008","journal-title":"Am J Physiol Endocrinol Metab"},{"issue":"1","key":"2019092505514020500_bib29","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1038\/jhh.2011.83","article-title":"To dip or not to dip? The unique relationship between different blood pressure patterns and cardiac function and structure","volume":"27","author":"Ivanovic","year":"2013","journal-title":"J Hum Hypertens"},{"issue":"2","key":"2019092505514020500_bib30","doi-asserted-by":"crossref","first-page":"e55419","DOI":"10.1371\/journal.pone.0055419","article-title":"Reversed dipper blood-pressure pattern is closely related to severe renal and cardiovascular damage in patients with chronic kidney disease","volume":"8","author":"Wang","year":"2013","journal-title":"PLoS One"},{"issue":"1","key":"2019092505514020500_bib31","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1161\/01.HYP.26.1.2","article-title":"Mechanical principles in arterial disease","volume":"26","author":"O\u2019Rourke","year":"1995","journal-title":"Hypertension"},{"issue":"2","key":"2019092505514020500_bib32","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1161\/01.HYP.0000111829.46090.92","article-title":"Increased central artery stiffness in impaired glucose metabolism and type 2 diabetes: the Hoorn Study","volume":"43","author":"Schram","year":"2004","journal-title":"Hypertension"},{"issue":"6","key":"2019092505514020500_bib33","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1097\/00041552-200211000-00010","article-title":"Prognostic significance of arterial stiffness measurements in end-stage renal disease patients","volume":"11","author":"Blacher","year":"2002","journal-title":"Curr Opin Nephrol Hypertens"},{"issue":"6","key":"2019092505514020500_bib34","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1001\/archinte.168.6.617","article-title":"Definition of kidney dysfunction as a cardiovascular risk factor: use of urinary albumin excretion and estimated glomerular filtration rate","volume":"168","author":"Cirillo","year":"2008","journal-title":"Arch Intern Med"},{"issue":"4","key":"2019092505514020500_bib35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/JAHA.116.004847","article-title":"Associations of blood pressure dipping patterns with left ventricular mass and left ventricular hypertrophy in blacks: the Jackson Heart Study","volume":"6","author":"Abdalla","year":"2017","journal-title":"J Am Heart Assoc"},{"issue":"3","key":"2019092505514020500_bib36","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/0002-8703(85)90582-4","article-title":"Does norepinephrine play a central causative role in the process of cardiac hypertrophy","volume":"109","author":"Rossi","year":"1985","journal-title":"Am Heart J"},{"issue":"2","key":"2019092505514020500_bib37","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4070\/kcj.2014.44.2.89","article-title":"Impact of pheochromocytoma on left ventricular hypertrophy and QTc prolongation: comparison with takotsubo cardiomyopathy","volume":"44","author":"Choi","year":"2014","journal-title":"Korean Circ J"},{"issue":"3","key":"2019092505514020500_bib38","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1093\/ajh\/5.3.134","article-title":"Differences in left ventricular structural and functional changes between pheochromocytoma and essential hypertension. Role of elevated circulating catecholamines","volume":"5","author":"Fouad-Tarazi","year":"1992","journal-title":"Am J Hypertens"},{"issue":"11","key":"2019092505514020500_bib39","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/0002-9149(86)90741-1","article-title":"Echocardiographic findings in pheochromocytoma","volume":"57","author":"Shub","year":"1986","journal-title":"Am J Cardiol"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/jc.2018-02644\/28489304\/jc.2018-02644.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/104\/11\/5170\/30051227\/jc.2018-02644.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T05:54:46Z","timestamp":1569390886000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/104\/11\/5170\/5475550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,22]]},"references-count":39,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2018-02644","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,11]]},"published":{"date-parts":[[2019,4,22]]}}}