Preoperative Medicine Treatment for Catecholamine-induced Cardiomyopathy in Patients with Pheochromocytoma/Paraganglioma

  Objective  The aim of this study was to discuss the preoperative medicine treatment and adjustment for catecholamine-induced cardiomyopathy in patients with pheochromocytoma/paraganglioma to ensure the safety of operation.

  Methods  The clinical information of patients with catecholamine-induced cardiomyopathy in pheochromocytoma/paraganglioma who underwent surgery in the Department of Urology at Peking Union Medical College Hospital from January 2007 to January 2019 was retrospectively collected and reviewed, including the clinical features, echocardiographic results, therapeutic strategies for catecholamine-induced cardiomyopathy, urinary catecholamine and its metabolites, and the cardiac function. The correlation between norepinephrine level and severity of catecholamine-induced cardiomyopathy was evaluated. Normal distribution quantitative data were expressed by mean±SD and analyzed by t test. The difference was statistically significant with P < 0.05.

  Results  Seventeen patients meeting the inclusive and exclusive criteria were enrolled in this study. All patients had mild to moderate heart failure. The left ventricular ejection fraction (LVEF) before and after the medication was (42.58±7.35)% and (56.0±7.09)% respectively (t=0.507, P=0.038).The LVEF of patients with catecholamine-induced cardiomyopathy in the high norepinephrine group and low norepinephrine group were (43.11±5.79)% and (42.0±9.19)% (t=0.015, P=0.973), and after treatment, (55.2±5.21)% and (56.87±9.07)% (t=-0.145, P=0.732) respectively.

  Conclusions  Medicine might improve the cardiac function of patients with catecholamine-induced cardiomyopathy in pheochromocytoma/paraganglioma. Norepinephrine level is not correlated with the severity of catecholamine-induced cardiomyopathy.