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This Article Accepted manuscript (PDF) All Versions of this Article: EJE-08-0126v1 159/2/137    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Giampaolo, B. Articles by Salvetti, A. Search for Related Content PubMed PubMed Citation Articles by Giampaolo, B. Articles by Salvetti, A.

Normalization of catecholamine production following resection of pheochromocytoma positively influences carotid vascular remodeling

B Giampaolo, Department of Internal Medicine, University of Pisa, Pisa, Italy
F Galetta, Department of Internal Medicine, University of Pisa, Pisa, Italy
F Franzoni, Pisa, Italy
M Bardini, pisa, Italy
C Taurino, pisa, Italy
A Moretti, Pisa, Italy
M Bernini, Pisa, Italy
P Berti, Department of Surgery, University of Pisa, Pisa, Italy
P Miccoli, Pisa, Italy
A Salvetti, Pisa, Italy

Correspondence: Bernini Giampaolo, Email: g.bernini{at}med.unipi.it

Abstract

Objective. To evaluate the influence of plasma catecholamines on the vascular structure in humans the effects of catecholamine normalization on the carotid wall of patients with pheochromocytoma (PHEO) were investigated. A prospective study in patients with PHEO before and after (first follow-up: 20.5±1.8 months, second follow-up: 31.5±2.2 months) successful surgery was conducted in a University Referral Center for Blood Pressure Diseases. Ten consecutive patients with PHEOs and ten age- and blood pressure- matched controls were investigated. Intima Media Thickness (IMT) by two-dimensional conventional ultrasonography and Corrected Ultrasonic Backscatter Analysis (C-IBS) of carotid arteries were investigated in basal conditions and after mass removal.

Results. In PHEOs, at variance with the expected reduction in metanephrines and catecholamines, no variation in body weight, blood pressure and lipid profile was observed after operation. IMT and C-IBS values in patients with PHEO were greater (p <0.01 at least) than in controls. At long term follow-up after surgery a significant reduction in mean carotid IMT (p <0.0009) and C-IBS (p <0.009) values was observed. A significant correlation (r=0.54, p< 0.03) was found between absolute reduction in C-IBS values and absolute decrement in urinary normetanephrines levels.

Conclusions. Our study shows that normalization of catecholamine levels after removal of PHEO improves carotid IMT and reduces carotid wall fibrosis even without influencing blood pressure and lipid profile. These findings confirm that high catecholamine tone in humans directly influences vascular remodeling of carotid arteries.