Catecholamine-Induced Cardiomyopathy in Pheochromocytoma: How to Manage a Rare Complication in a Rare Disease?

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme
Jenn Rachelle U SantosKarel Pacak

Abstract

Pheochromocytomas and paragangliomas (PHEOs) are rare neuroendocrine tumors. Clinical manifestations include different cardiovascular signs and symptoms, which are related to excessive secretion of catecholamines. Catecholamine-induced cardiomyopathy in PHEO (CICMPP) is a rare but dreaded complication of PHEO. Once patient is diagnosed with this condition, the prognosis is worse and a surgical risk is much higher than expected. This article focuses on how catecholamines affect the heart and the pathophysiologic mechanism of CICMPP. The cardiovascular responses to catecholamine depend mostly on which catecholamine is released as well as the amount of catecholamine that is released. The acute release of norepinephrine and epinephrine from PHEO increases heart rate, systemic vascular resistance, myocardial contractility, and reduces venous compliance. The excessive adrenergic stimulation by catecholamine results in severe vasoconstriction and coronary vasospasm, myocardial ischemia, and subsequently damage, and necrosis. Chronically elevated catecholamine levels lead to significant desensitization of cardiac β-adrenoceptors. The increased levels of the enzyme β-adrenoceptors kinase (βARK) in the heart seems to mediate these bioche...Continue Reading

Citations

Aug 6, 2020·Journal of Clinical Medicine·Shams Y-Hassan, Henrik Falhammar
Jul 6, 2019·Heart Failure Reviews·Kalliopi KeramidaDimitrios Farmakis
Nov 26, 2020·Journal of Community Hospital Internal Medicine Perspectives·Joel ThekekaraJoe N Hackworth
Feb 10, 2021·A&A Practice·Benjamin S LevinWilliam J Sauer
Mar 21, 2021·BMJ Case Reports·Masaki ItaganeMitsuyo Kinjo
Jul 25, 2020·Journal of the American College of Cardiology·Matthew A NazariKarel Pacak

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