Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Mar 26, 2017; 9(3): 255-260
Published online Mar 26, 2017. doi: 10.4330/wjc.v9.i3.255
Pheochromocytoma and stress cardiomyopathy: Insight into pathogenesis
Sahil Agrawal, Jamshid Shirani, Lohit Garg, Amitoj Singh, Santo Longo, Angelita Longo, Mark Fegley, Lauren Stone, Muhammad Razavi, Nicoleta Radoianu, Sudip Nanda
Sahil Agrawal, Jamshid Shirani, Lohit Garg, Amitoj Singh, Santo Longo, Angelita Longo, Mark Fegley, Lauren Stone, Muhammad Razavi, Nicoleta Radoianu, Sudip Nanda, Department of Cardiology, St. Luke’s University Health Network, Bethlehem, PA 18015, United States
Author contributions: All the authors contributed to the manuscript.
Institutional review board statement: The study protocol was approved by the IRB at St. Luke’s University Health Network, Bethlehem.
Informed consent statement: Not applicable due to data anonymization and retrospective design of the study.
Conflict-of-interest statement: All authors report no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sahil Agrawal, MD, Department of Cardiology, St. Luke’s University Health Network, 801 Ostrum Street, Bethlehem, PA 18015, United States. sahilagrawal124@gmail.com
Telephone: +1-484-5264011 Fax: +1-484-5264010
Received: September 4, 2016
Peer-review started: September 7, 2016
First decision: September 26, 2016
Revised: November 28, 2016
Accepted: December 16, 2016
Article in press: December 19, 2016
Published online: March 26, 2017
Core Tip

Core tip: A non-ischemic cardiomyopathy (CMP) may be observed in patients with pheochromocytoma and shares several features with takotsubo cardiomyopathy. Although it is believed that pheochromocytoma related CMP is due to the catecholamine excess, the exact pathogenesis is unclear. CMP in pheochromocytoma patients often follows acute stress and while clinical course maybe complicated by acute hemodynamic compromise, prognosis is good. On the basis of our findings, where 3 of 18 pheochromocytoma patients developed an acute CMP, we suggest that activation of a brain-neural-cardiac axis from acute stress and local release of catecholamines but not chronic catecholamine elevations may likely be responsible for pheo related CMP.