Markers of Subclinical Cardiovascular Disease in Patients with Adrenal Incidentaloma

Abstract

Due to the growing availability of imaging examinations the percentage of patients with incidentally diagnosed adrenal tumors has increased. The vast majority of these lesions are benign, non-functioning adenomas, although according to various estimates even up to 30%–50% of patients with adrenal incidentaloma may present biochemical hypercortisolemia, without typical clinical features of Cushing’s syndrome. Adrenal adenomas secreting small amounts of glucocorticoids may cause morphological and functional changes in the myocardium and blood vessels. Early stages of cardiovascular remodeling may be observed among asymptomatic patients with adrenal adenoma. Vascular changes precede the development of cardiovascular diseases and can increase morbidity and mortality in patients with adrenal incidentaloma. This risk may result not only from the traditional risk factors. Seemingly hormonally inactive adrenal tumors can indeed produce small amounts of glucocorticoids that have metabolic implications. Therefore, evaluation of patients with incidental adrenal findings presenting with subclinical cardiovascular disease seems of particular importance.

A Rare Case of Obstructed Recurrent Incisional Hernia With Incidentalomas

“…Adrenal adenomas are associated with a high degree of occurrence of adverse cardiovascular events as well as the presence of atherosclerosis, hypertension, and diabetes mellitus, as seen in this patient [ 10 ]. The vascular calcification in the aorta and the common iliac arteries are common findings, usually subclinical, in males above 60 years of age [ 11 ] and may be a metabolic consequence of the adrenal incidentaloma secreting small amounts of glucocorticoids [ 12 ]. Adrenal cystic lesions are an uncommon occurrence per se and are discovered incidentally or sometimes are symptomatic.…”

Thyroid, Gonadal and Adrenal Dysfunction in Kidney Transplant Recipients: A Review for the Clinician

“…Cushing syndrome, as well as subclinical hypercortisolism, are associated with increased cardiovascular and metabolic risk in the general population [ 95 ]. Whether the subclinical hypercortisolism encountered in CKD patients contributes to the increased CVD burden and mortality is still largely unexplored.…”