Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter
  • Published:

“Resistant hypertension, catecholamine excess, left ventricular hypertrophy and systolic dysfunction: hypertensive cardiomyopathy?”

Journal of Human Hypertension volume 37, pages 1129–1130 (2023)Cite this article

Subjects

Raised catecholamines in patients with hypertension might represent a feature of pheochromocytoma/paraganglioma or be ascribed to several other conditions whose differential diagnosis is often challenging in clinical practice. In these patients, cardiac imaging is also important to evaluate the presence and severity of cardiomyopathy to which catecholamines excess can be a contributing factor.

A 39-year-old man of African descent was referred to the hypertension clinic with uncontrolled hypertension. He had been diagnosed with hypertension in his early twenties, and had been initiated on pharmacological treatment. His drug history consisted of amlodipine 5 mg, ramipril 2.5 mg and indapamide 2.5 mg daily and HIV pre-exposure prophylaxis (emtricitabine 200 mg/tenofovir disoproxil 245 mg daily). Other past medical history was largely unremarkable apart from included resolved acute pericarditis and iron deficiency anaemia secondary to haemorrhoidal bleeding. There was a maternal history of diabetes and cardiovascular disease, but no family history of hypertension. He was a non-smoker and reported no recent alcohol or drug abuse.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Left ventricular hypertrophy before and after treatment optimization.

References

  1. Bhogal S, Ladia V, Sitwala P, Cooke E, Bajaj K, Ramu V, et al. Cardiac amyloidosis: an updated review with emphasis on diagnosis and future directions. Curr Probl Cardiol. 2018;43:10–34. https://doi.org/10.1016/j.cpcardiol.2017.04.003.

    Article  PubMed  Google Scholar 

  2. Quarta G, Aquaro GD, Pedrotti P, Pontone G, Dellegrottaglie S, Iacovoni A, et al. Cardiovascular magnetic resonance imaging in hypertrophic cardiomyopathy: the importance of clinical context. Eur Heart J Cardiovasc Imaging. 2018;19:601–10. https://doi.org/10.1093/ehjci/jex323.

    Article  PubMed  Google Scholar 

  3. Martin CA, Lambiase PD. Pathophysiology, diagnosis and treatment of tachycardiomyopathy. Heart. 2017;103:1543–52. https://doi.org/10.1136/heartjnl-2016-310391.

    Article  PubMed  Google Scholar 

  4. Tsirlin A, Oo Y, Sharma R, Kansara A, Gliwa A, Banerji MA. Pheochromocytoma: a review. Maturitas. 2014;77:229–38. https://doi.org/10.1016/j.maturitas.2013.12.009.

    Article  CAS  PubMed  Google Scholar 

  5. Itani M, Mhlanga J. Imaging of pheochromocytoma and paraganglioma. In: Mariani-Costantini R, ed. Paraganglioma: a multidisciplinary approach. 1st ed. Codon Publications; 2019:41–61. https://doi.org/10.15586/paraganglioma.2019.ch3.

  6. Ergin A, Kennedy A, Gupta M, Hamrahian A. The Cleveland clinic manual of dynamic endocrine testing. 1st ed. (Ergin A, Kennedy A, Gupta M, Hamrahian A, eds.). Springer International Publishing; 2015. https://doi.org/10.1007/978-3-319-13048-4.

  7. Mamilla D, Gonzales MK, Esler MD, Pacak K. Pseudopheochromocytoma. Endocrinol Metab Clin North Am. 2019;48:751–64. https://doi.org/10.1016/j.ecl.2019.08.004.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Baguet JP, Barone-Rochette G, Pépin JL. Hypertension and obstructive sleep apnoea syndrome: Current perspectives. J Hum Hypertens. 2009;23:431–43. https://doi.org/10.1038/jhh.2008.147.

    Article  PubMed  Google Scholar 

  9. Morselli F, Fang L, Ambrosini I, Chowienczyk PJ, Faconti L. Uncertain etiology of left ventricular hypertrophy in a young subject with hypertension treated with dexamphetamine. Am J Med. 2020;133:e227–e229. https://doi.org/10.1016/j.amjmed.2019.09.029.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    Allon Gould

  2. Department of Translational Research, Academic Radiology, University of Pisa, Pisa, Italy

    Ilaria Ambrosini

  3. School of Biomedical Engineering and Imaging Sciences, King’s College London Guy’s and St Thomas NHS Trust Foundation, London, UK

    Pier-Giorgio Masci

  4. School of Cardiovascular Medicine & Sciences, King’s College London Guy’s and St Thomas NHS Trust Foundation, London, UK

    Ryan John Mcnally, Philip J. Chowienczyk & Luca Faconti

Authors
  1. Allon Gould
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ilaria Ambrosini
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pier-Giorgio Masci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ryan John Mcnally
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Philip J. Chowienczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Luca Faconti
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AG and IA conceived the idea. LF and PC supervised the care of the patient described in the case. AG and LF made the diagnosis and clinically managed the patient, and alongside RM had direct patient contact. All authors worked on the interpretation of the results, discussed the results and worked on the manuscript. PGM carried out the MRI/MRA and provided clinical information on the outcome. All authors provided critical feedback and helped shape the manuscript and approved the final version. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Luca Faconti.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gould, A., Ambrosini, I., Masci, PG. et al. “Resistant hypertension, catecholamine excess, left ventricular hypertrophy and systolic dysfunction: hypertensive cardiomyopathy?”. J Hum Hypertens 37, 1129–1130 (2023). https://doi.org/10.1038/s41371-023-00852-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41371-023-00852-8

Search

Advanced search

Quick links