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Early cardiac dysfunction in obese adolescents with Down syndrome or autism

Published online by Cambridge University Press:  03 October 2022

Geetha Haligheri Open the ORCID record for Geetha Haligheri [Opens in a new window] ,
Tyler Johnson ,
Melanie Kathol ,
Laura Kuzava ,
Natalie Goth ,
Vincent S. Staggs ,
Joseph E. Donnelly ,
Lauren T. Ptomey  and
Dan Forsha Open the ORCID record for Dan Forsha [Opens in a new window]
Geetha Haligheri*
Affiliation:
Children’s Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA University of Missouri – Kansas City, Department of Pediatrics, Kansas City, MO, USA
Tyler Johnson
Affiliation:
Children’s Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
Melanie Kathol
Affiliation:
Children’s Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
Laura Kuzava
Affiliation:
Children’s Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
Natalie Goth
Affiliation:
Children’s Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
Vincent S. Staggs
Affiliation:
Children’s Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA
Joseph E. Donnelly
Affiliation:
University of Kansas Medical Center, Kansas City, KS, USA
Lauren T. Ptomey
Affiliation:
University of Kansas Medical Center, Kansas City, KS, USA
Dan Forsha
Affiliation:
Children’s Mercy Hospital, Department of Pediatric Cardiology, Kansas City, MO, USA University of Missouri – Kansas City, Department of Pediatrics, Kansas City, MO, USA
*
Author for correspondence: Geetha Haligheri, MD, FASE, FACC, Pediatric Cardiologist, Clinical Assistant Professor, University of Missouri-Kansas School of Medicine, Children’s Mercy Hospital, Kansas City, MO, USA. E-mail: [email protected]
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Abstract

Background:

Obesity in adolescents with intellectual and developmental disabilities) occurs at twice the frequency as their typically developing peers. Typically developing adolescents with obesity have abnormal cardiac function (as measured by strain echocardiography) and cardiac mass, but the effects of obesity on cardiac health in adolescents with Down syndrome or autism spectrum disorder are unknown. The purpose of this study was to evaluate the impact of body mass index on cardiac function in adolescents with Down syndrome or autism.

Methods:

Adolescents (age 12–21 years) with Down syndrome (n = 28), autism (n = 33), and age-/sex-matched typically developing controls (n = 15) received an echocardiogram optimised for strain analysis at a single timepoint. Measures of ventricular function, mass, and size were collected. Regression modelling evaluated the impact of body mass index and intellectual and developmental disabilities diagnosis on these cardiac measures.

Results:

In regression modelling, an elevated body mass index z-score was associated with diminished systolic biventricular function by global strain (left ventricular longitudinal strain β 0.87, P < 0.001; left ventricular circumferential strain β 0.57, p 0.003; right ventricular longitudinal strain β 0.63, P < 0.001). Diminished left ventricular diastolic function by early diastolic strain rate was also associated with elevated body mass index (global longitudinal end-diastolic strain rate β −0.7, P < 0.001). No association was found between traditional (non-strain) measures of systolic and diastolic ventricular function and body mass index z-score.

Conclusions:

Obesity in adolescents with Down syndrome or autism negatively impacts cardiac function as measured by echocardiographic strain analysis that was not detected by traditional parameters.

Keywords

Cardiac dysfunctionpaediatric obesityIntellectual and developmental disabilitiesMyocardial strainBody mass indexLeft ventricular mass
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 9 , September 2023 , pp. 1678 - 1685
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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