Aim

Information on systolic dysfunction, as assessed by left-ventricular (LV) mechanics, in patients with pheochromocytoma after surgical treatment is scanty. We performed a systematic meta-analysis of speckle tracking echocardiographic studies to provide an updated comprehensive information on this issue.

Methods

The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search for articles published from the inception up to May 31st 2021. Studies were identified using MeSH terms and crossing the following search items: “myocardial strain” “left ventricular mechanics”, “speckle tracking echocardiography”, “systolic dysfunction”, “pheochromocytoma”, and “paraganglioma”.

Results

A total of 92 surgically treated patients with pheochromocytoma/paraganglioma were included in 3 longitudinal studies. Successful surgical treatment was associated with a decrease in relative wall thickness (SMD − 0.25 ± 0.10, CI − 0.45/− 0.05, p < 0.01) and an improvement in global longitudinal strain (SMD − 0.45 ± 0.10, CI − 0.66/− 0.24, p < 0.0001). The favorable effects of treatment on LV geometry and mechanics were not accompanied by significant changes in ejection fraction (SMD − 0.07 ± 0.10, CI − 0.27/0.12, p = 0.44).

Conclusions

This meta-analysis adds a new piece of evidence, suggesting that surgical treatment of patients with pheochromocytoma impacts favorably on LV geometry and LV mechanics, and, more importantly, the assessment of LV changes in this setting can no longer rely on conventional echocardiographic parameters such as ejection fraction.

中文翻译：

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手术治疗对嗜铬细胞瘤和副神经节瘤患者心肌劳损的影响：一项小型回顾和荟萃分析

目标

通过左心室 (LV) 力学评估的关于手术治疗后嗜铬细胞瘤患者的收缩功能障碍的信息很少。我们对斑点跟踪超声心动图研究进行了系统的荟萃分析，以提供有关此问题的最新综合信息。

方法

对 PubMed、OVID-MEDLINE 和 Cochrane 图书馆数据库进行了分析，以搜索从成立到 2021 年 5 月 31 日发表的文章。使用 MeSH 术语并交叉以下搜索项目确定研究：“心肌劳损”“左心室力学”， “斑点追踪超声心动图”、“收缩功能障碍”、“嗜铬细胞瘤”和“副神经节瘤”。

结果

3 项纵向研究共纳入 92 名接受手术治疗的嗜铬细胞瘤/副神经节瘤患者。成功的手术治疗与相对壁厚的减少（SMD - 0.25 ± 0.10，CI - 0.45/- 0.05，p  < 0.01）和整体纵向应变的改善（SMD - 0.45 ± 0.10，CI - 0.66/- 0.24 , p  < 0.0001)。治疗对 LV 几何形状和力学的有利影响并未伴随射血分数的显着变化（SMD - 0.07 ± 0.10，CI - 0.27/0.12，p  = 0.44）。

结论

这项荟萃分析增加了一条新证据，表明对嗜铬细胞瘤患者的手术治疗对 LV 几何形状和 LV 力学有积极影响，更重要的是，在这种情况下对 LV 变化的评估不再依赖于传统的超声心动图参数，例如作为射血分数。