home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Original Article • Arq. Bras. Cardiol. 121 (6) • 2024 • https://doi.org/10.36660/abc.20230442i linkcopy

Echocardiographic Alterations of Cardiac Geometry and Function in Patients with Familial Partial Lipodystrophy

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background: Cardiomyopathy associated with partial lipodystrophy (PL) has not been well described yet.

Objective: To characterize cardiac morphology and function in PL.

Methods: Patients with familial PL and controls were prospectively assessed by transthoracic echocardiography and with speckle-tracking echocardiography (global longitudinal strain, GLS). The relationship between echocardiographic variables and PL diagnosis was tested with regression models, considering the effect of systolic blood pressure (SBP). Significance level of 5% was adopted.

Results: Twenty-nine patients with PL were compared to 17 controls. They did not differ in age (p=0.94), gender or body mass index (p= 0.05). Patients with PL had statistically higher SBP (p=0.02) than controls. Also, PL patients had higher left atrial dimension (37.3 ± 4.4 vs. 32.1 ± 4.3 mm, p= 0.001) and left atrial (30.2 ± 7.2 vs. 24.9 ± 9.0 mL/m²,p=0.02), left ventricular (LV) mass (79.3 ± 17.4 vs. 67.1 ± 19.4, p=0.02), and reduced diastolic LV parameters (E’ lateral, p= 0.001) (E’ septal, p= 0.001), (E/E’ ratio, p= 0.02). LV ejection fraction (64.7 ± 4.6 vs. 62.2 ± 4.4 %, p= 0.08) and GLS were not statistically different between groups (-17.1 ± 2.7 vs. -18.0 ± 2.0 %, p= 0.25). There was a positive relationship of left atrium (β 5.6, p<0.001), posterior wall thickness, (β 1.3, p=0.011), E’ lateral (β -3.5, p=0.002) and E’ septal (β -3.2, p<0.001) with PL diagnosis, even after adjusted for SBP.

Conclusion: LP patients have LV hypertrophy, left atrial enlargement, and LV diastolic dysfunction although preserved LVEF and GLS. Echocardiographic parameters are related to PL diagnosis independent of SBP.

Keywords: Lipodystrophy; Heart Function Tests; Echocardiography

Variable		Control	PL	p
n		17	29
Age (y)		43.84 ± 13.32	44.58 ± 11.77	0.94
Male gender (%)		0.00	27.00
Weight (Kg)		64.33 ± 13.69	68.66 ± 17.92	0.41
BMI (Kg/m²)		24.52 ± 5.04	26.73 ± 4.30	0.05
BSA (m²)		1.676 ± 0.16	1.70 ± 0.23	0.9
Pathogenic Variant
	r482w	0	12
	r644c	0	5
Clinical charcacteristic
	Glycemia (mg/dl)	88.39 (83.50-96.00)	128.50 (89.06-206)	<0.0001*
	HBA1C (%)	5.45 (4.92-5.87)	8.70 (5.8-11.40)	<0.0001*
	HDL (mg/dl)	55.00 (40.50-61.25)	35.61 (31.04-42.32)	0.01*
	LDL (mg/dl)	104 (84-142)	110.00 (70.50-163.65)	0.58
	TG(mg/dl)	86 (67.50-124)	221.80 (162.00-406.40)	<0.0001*
	SBP (mmHg)	111.00 (101-117)	123.5 (112-134)	0.02*
	DBP (mmHg)	69 (62-72)	75(66-82)	0.1
Medication (%)
	Insulin	0	51.7
	Metformin	0	41.37
	Gliclazide	0	3.44
	Statin	0	41.37
	Fibrates	0	68.96
	Anti-hipertensive	5	68.96

Variable	Control	PL	p
LA dimension (mm)	32 (28.5-33.75)	38 (34.25-40.00)	0.001^* * =p<0.05.
LAVi (ml/m²)	26.26 (20.41-30.89)	30 (26-32.90)	0.023^* * =p<0.05.
LVmass i(ml/m²)	67.54 (49.60-79.79)	77.34 (67.21-88.29)	0.022^* * =p<0.05.
LVEF Simpson (%)	63.50 (59.25-65.75)	64.50 (61-67.50)	0.77
IVS thickness (mm)	8.00 (7-9)	9 (8-11)	0.003^* * =p<0.05.
LVDD (mm)	44.50 (40.50-48.50)	43 (41-47)	0.526
PWT (mm)	7.5 (6.50-8.87)	9 (8-10)	0.001^* * =p<0.05.
LVSD (mm)	21.25 (18.13- 24)	20 (15-25)	0.985
LVDV (ml)	57 (47.93-63)	56 (45.50-77.50)	0.345
E (cm/s)	82 (69-96)	74 (54-83)	0.016^* * =p<0.05.
A (cm/s)	59 (48-73)	69 (53-80)	0.197
E/a	0.891 (0.61-1.54)	2.19 (1.68-3.54)	0.035^* * =p<0.05.
e' lat (cm/s)	15 (12-17)	11 (9-14)	<0.0001
e' sep (cm/s)	10 (10-14)	8 (6-11)	<0.0001
Deceleration time (mseg)	186 (175.3-217.3)	180 (162-244)	0.45
e´AVG	12.5 (11.5-15.5)	9 (7-12)	<0.0001
E/e´	6.19 (5.15-7.55)	7.38 (6-9.1)	0.017^* * =p<0.05.
GLS (%)	-18.05 (-19.78- - 17.09)	-16.95 (-19.05- -15.10)	0.252

Variable	GLS > -16%	GLS < -16%	p
n	12	9
LA dimension (mm)	36.15 ± 4.547	39 (34.58-41.50)	0.315
LAVi (mL/m2)	29.30 (26-30.85)	31 (27.60- 35.89)	0.142
LV mass i(mg/m2)	80.23 (67.29-89.34)	60.69 (51.72-69.27)	0.01^* * =p<0.05.
LVEF Simpson (%)	63.5 (58.50-65)	60.69 (51.72-69.27)	0.316
IVS thickness (mm)	11 (10-12)	8 (7-9)	0.003^* * =p<0.05.
LVDD (mm)	38 (35-39)	44 (40.75-48)	<0.0001^* * =p<0.05.
PWT (mm)	11 (10-12)	9 (8-10)	0.001^* * =p<0.05.
LVSD (mm)	16.5 (14-22)	20 (15.5- 22.5)	0.99
LVDV (ml)	52.5 (43-62.5)	56 (46.5-65.5)	0.35
E (cm/s)	60.5 (54-76)	85 (72.5-96.5)	0.02^* * =p<0.05.
A (cm/s)	73 (60-80)	74 (64-82)	0.61
E/a	0.68 (0.49-0.97)	2.24 (1.68-2.87)	0.045^* * =p<0.05.
e' lat (cm/s)	8 (7-9)	12 (10.5-13.5)	<0.0001^* * =p<0.05.
e' sep (cm/s)	6 (5-7)	10 (8.5-12)	<0.0001^* * =p<0.05.
Deceleration time (mseg)	180 (169-264)	184 (156-267)	0.0067^* * =p<0.05.
e´AVG	7 (6-8.5)	9 (7.25-11.75)	0.002^* * =p<0.05.
E/e´	10.99 (10.33-12.93)	7.46 (6.57-8.83)	<0.0001^* * =p<0.05.

	Univariate Analyses			Multivariate analyses
Variable	Coefficient (β)	SE	p-value	Coefficient (β)	SE	p-value
LA dimension (mm)	5.6	1.3	<0.001^* * =p<0.05.	5.2	1.6	0.003^* * =p<0.05.
LAVi (mL/m²)	3.4	2.7	0.21	2.6	3.1	401
LV mass (mg/m²)	10.4	4.8	0.08	13.7	6.3	0.038^* * =p<0.05.
LVEF Simpson (%)	1.3	1.5	0.39	1.6	1.7	373
IVS thickness (mm)	1.3	0.5	0.011^* * =p<0.05.	1.3	0.6	0.032^* * =p<0.05.
LVDD (mm)	-1.9	2.1	0.37	-1.8	2.6	0.486
PWT (mm)	1.2	0.4	0.004^* * =p<0.05.	1.2	0.5	0.016^* * =p<0.05.
LVDV (mL)	5	6.3	0.43	-1.4	7.1	0.849
E (cm/s)	-10.3	5.3	0.06	-8.7	6.1	0.165
A (cm/s)	8.1	5.8	0.17	8	6.5	0.227
e' lat (cm/s)	-3.5	1.1	0.002^* * =p<0.05.	-3.5	1.1	0.003^* * =p<0.05.
e' sep (cm/s)	-3.2	0.8	<0.001^* * =p<0.05.	-3	0.9	0.001^* * =p<0.05.
Deceleration time (mseg)	13.1	17.1	0.477	4.7	17.3	0.788
e´AVG	-3.5	0.9	<0.001^* * =p<0.05.	-3.3	0.9	0.001^* * =p<0.05.
E/e´	1.5	0.6	0.021^* * =p<0.05.	1.6	0.7	0.035^* * =p<0.05.
GLS (%)	1.1	0.8	0.207	1.6	0.9	0.92

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Sociedade Brasileira de Cardiologia - SBC Avenida Marechal Câmara, 160, sala: 330, Centro, CEP: 20020-907, (21) 3478-2700 - Rio de Janeiro - RJ - Brazil, Fax: +55 21 3478-2770 - São Paulo - SP - Brazil
E-mail: revista@cardiol.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro