Hypertension and Cardiac Damage in Pheochromocytoma and Paraganglioma Patients: A 598 Single-Center Cohort Study

Abstract

Abstract Background Hypertension (HT) and cardiac damage are the most common complications in pheochromocytoma and paraganglioma (PPGL). Although cardiovascular manifestations have been concerned in previous studies, the profile of HT and cardiac structure and function alteration in a large cohort of PPGL were rarely reported. In this study, we focused on HT prevalence and left ventricular remodeling (LVR) in a consecutive PPGL cohort. Materials and methods Five hundred and ninety-eight consecutive patients who underwent surgery for PPGL in a single center from January 2001 to April 2022 were enrolled. Demographic data, cause of hospitalization, medical history, biochemical examinations, echocardiography results and characteristics of tumors were recorded. And patients were grouped by HT history. Results The average age was 47.07 ± 15.07 years and 277 (46.32%) of the patients were male. Out of 598 PPGL patients, 423(70.74%) had HT history. Comparing with non-HT group, HT group had higher rate of ectopic tumor (26.00% vs. 17.71%, P = 0.030) and less likelihood been found incidentally during health examination (22.93% vs. 59.43%, P < 0.001). Left ventricular mass index (LVMI) (86.58 ± 26.70 vs. 75.80 ± 17.26, P < 0.001) and relative wall thickness (RWT) (0.43 ± 0.08 vs. 0.41 ± 0.06, P = 0.012) was larger in PPGL patients with HT history than the patients without HT history. And the proportion of left ventricular hypertrophy (LVH) (19.40% vs. 8.25%, P = 0.011) and LVR (53.73% vs. 39.18%, P = 0.014) was higher in HT history group comparing with the other. After adjusting for age, sex, BMI, drink, smoke, diabetes, stroke, creatinine, ectopic tumor and tumor size, HT history was significantly correlated with LVH (OR:2.71; 95% CI, 1.18—6.19; P = 0.018) and LVR (OR:1.83; 95% CI, 1.11—3.03; P = 0.018). Conclusion HT was common (70.74% in this cohort) in PPGL. PPGL without HT history was more likely been found incidentally (59.43% in this cohort). HT was associated with LVR in PPGL patients. Cardiac damage with LVH/LVR should be payed attention in PPGL especially in those with HT.