{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T05:08:49Z","timestamp":1793768929354,"version":"4.6.1"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017244","name":"Wojskowy Instytut Medyczny","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017244","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Cushing\u2019s disease is a rare condition associated with a high cardiovascular risk and hypercortisolemia-related hemodynamic dysfunction, the extent of which can be assessed with a noninvasive method, called impedance cardiography. The standard methods for hemodynamic assessment, such as echocardiography or ambulatory blood pressure monitoring may be insufficient to fully evaluate patients with Cushing\u2019s disease; therefore, impedance cardiography is being currently considered a new modality for assessing early hemodynamic dysfunction in this patient population. The use of impedance cardiography for diagnosis and treatment of Cushing\u2019s disease may serve as personalized noninvasive hemodynamic status assessment and provide a better insight into the pathophysiology of Cushing\u2019s disease. The purpose of this study was to assess the hemodynamic profile of Cushing\u2019s disease patients and compare it with that in the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This observational prospective clinical study aimed to compare 54 patients with Cushing\u2019s disease (mean age 41 years; with 64.8% of this population affected with arterial hypertension) and a matched 54-person control group (mean age 45 years; with 74.1% of this population affected with arterial hypertension). The\u00a0hemodynamic parameters assessed with impedance cardiography included the stroke index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), (ACI), Heather index (HI), and thoracic fluid content (TFC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Cushing\u2019s disease group was characterized by a higher diastolic blood pressure and a younger age than the control group (82.9 <jats:italic>vs.<\/jats:italic> 79.1 mmHg, p=0.045; and 41.1 <jats:italic>vs.<\/jats:italic> 44.9 years, p=0.035, respectively). Impedance cardiography parameters in the Cushing\u2019s disease group showed: lower values of SI (42.1 <jats:italic>vs.<\/jats:italic> 52.8 ml\/m<jats:sup>2<\/jats:sup>; p \u2264 0.0001), CI (2.99 <jats:italic>vs.<\/jats:italic> 3.64 l\/min\/m<jats:sup>2<\/jats:sup>; p \u2264 0,0001), VI (42.9 <jats:italic>vs.<\/jats:italic> 52.1 1\/1000\/s; p=0.001), ACI (68.7 <jats:italic>vs.<\/jats:italic> 80.5 1\/100\/s<jats:sup>2<\/jats:sup>; p=0,037), HI (13.1 <jats:italic>vs.<\/jats:italic> 15.2 Ohm\/s<jats:sup>2<\/jats:sup>; p=0.033), and TFC (25.5 <jats:italic>vs.<\/jats:italic> 27.7 1\/kOhm; p=0.006) and a higher SVRI (2,515 <jats:italic>vs.<\/jats:italic> 1,893 dyn*s*cm<jats:sup>-5<\/jats:sup>*m<jats:sup>2<\/jats:sup>; p \u2264 0.0001) than those in the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cushing\u2019s disease is associated with significantly greater vasoconstriction and left ventricular systolic dysfunction. An individual assessment with impedance cardiography may be useful in Cushing\u2019s disease patients in order to identify subclinical cardiovascular complications of chronic hypercortisolemia as potential therapeutic targets.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.751743","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T12:13:54Z","timestamp":1633090434000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Cushing\u2019s Disease: Assessment of Early Cardiovascular Hemodynamic Dysfunction With Impedance Cardiography"],"prefix":"10.3389","volume":"12","author":[{"given":"Agnieszka","family":"Jurek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Krzesi\u0144ski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Gielerak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Przemys\u0142aw","family":"Witek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Zieli\u0144ski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kazimierczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Wierzbowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Banak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Uzi\u0119b\u0142o-\u017byczkowska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.ecl.2007.10.010","article-title":"Cushing\u2019s Syndrome","volume":"37","author":"Pivonello","year":"2008","journal-title":"Endocrinol Metab Clin North Am"},{"key":"B2","article-title":"Complications of Cushing\u2019s Disease - Prospective Evaluation and Clinical Characteristics. 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