Abstract 15854: Early Cardiac Dysfunction in Obese Adolescents With Intellectual and Developmental Disabilities (idd)

Abstract

Early cardiac dysfunction in obese adolescents with intellectual and developmental disabilities (IDD)Background: Adolescents with IDD (IQ range 40-74) are more frequently obese than the general population and the IDD population has a higher risk of early cardiovascular (CV) mortality in adulthood. The relationship between obesity and echo strain has not been studied in those with IDD. We hypothesize that obese adolescents with IDD will have diminished LV strain vs non-obese controls. Methods: Non-obese (21/50; < 95 th %ile BMI) and obese (29/50; > 95 th %ile BMI) adolescents with IDD (Down syndrome (DS) or autism) were enrolled excluding those with congenital heart disease. Echo LV systolic measures included ejection fraction (bullet), myocardial performance index (MPI; tissue Doppler), 2D global longitudinal systolic strain (GLS), strain rate (GLSr) and global circumferential strain (GCS). LV diastolic measures were E/e’ and LV early diastolic strain rate (LV ED Sr). The RV measures included RV GLS and TAPSE. Statistical analyses included unpaired t-tests and simple linear regression, p≤0.05 significant. Results: In 50 subjects (age 16.9, range 13.3-21.8 yrs; 27/50 males), LV GLS and GCS were mildly diminished with normal LV volume and ejection fraction (Table). The obese group had diminished LV strain compared to the non-obese group (P < 0.001). Increased BMI %ile predicted diminished LV GLS (P < 0.001) and GCS (P < 0.001) as well as LV ED Sr (P=0.001) on regression analysis. RV GLS was also mildly diminished in the total cohort but not significantly diminished in the obese group (p=0.06). Diastolic function (E/e’) was abnormally elevated in the DS subgroup (only difference found between DS and autism subgroups). Conclusions: Obese adolescents with IDD had abnormal LV strain measures not detected by traditional echo emphasizing the need for successful weight loss strategies focused on this special population.