Abstract
Background: Anorexia nervosa (AN) and obesity (OB) lead to changes in SBP (i.e., loading conditions) that may affect left ventricular (LV) myocardial work (MW). The novel concept of LV pressure-strain loops allows non-invasive estimation of MW, this latter being correlated with cardiac energy metabolism. In addition, the study of regional MW can detect subtle alterations in cardiac function by highlighting an abnormal distribution of MW. Objective: The aim of this study was to assess the cardiac function of AN and OB patients by evaluating global and regional LV strains and MW. Methods: Eighty-seven female adolescents, comprising 26 with AN (14.6 ± 1.9 yrs. old), 28 with OB (13.2 ± 1.4 yrs. old), and 33 controls (14.0 ± 2.0 yrs. old) underwent speckle-tracking echography to assess global and regional LV strains and MW. Results: SBP was higher in adolescents with obesity than in AN patients or controls. Global MW was similar between groups. In AN patients and controls, longitudinal strains were higher at the apex than at the base of the LV, whereas they were similar in obesity patients, owing to a decrease in their apical longitudinal strain. Consequently, their MW was higher at the basal level than either of the other two groups (1854 ± 272 vs. 1501 ± 280 vs. 1575 ± 295 mmHg% in OB patients, AN patients, and controls, respectively. Conclusion: Despite altered SBP, the global MW of adolescents with weight disorders was unaffected. However, in adolescents with obesity, the distribution of their regional LV MW was altered, which might reflect specific regional remodeling.
Highlights
Adolescent weight disorders are extremely common [1,2], ranging from anorexia nervosa (AN), defined by a significant weight loss [1,3] to obesity (OB), characterized by excess weight [2,4]
Whereas their left ventricular (LV) systolic and diastolic functions seemed preserved [1,2,7], the opposite effects have been observed on arterial blood pressure (BP), with lower systolic BP (SBP)
Wewe demonstrate thatthat global was ofalteration alteration loading conditions demonstrate global similar between patients, OB patients and and controls, related to their concomitant alterwas similar between patients, OB patients controls, related to their concomitant ations of BP
Summary
Adolescent weight disorders are extremely common [1,2], ranging from anorexia nervosa (AN), defined by a significant weight loss [1,3] to obesity (OB), characterized by excess weight [2,4]. Analysis of the Framingham Heart Study revealed that obese individuals had twice the risk of heart failure over a mean follow-up of 14 years [6] Whereas their left ventricular (LV) systolic and diastolic functions seemed preserved [1,2,7], the opposite effects have been observed on arterial blood pressure (BP), with lower systolic BP (SBP). In adolescents with obesity, the distribution of their regional LV MW was altered, which might reflect specific regional remodeling
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