Evaluation of coronary microvascular dysfunction and risk factors in children and youth with Turner syndrome by magnetic resonance myocardial perfusion imaging

Wei Bai; Wei Huang; Rong Xu; Hang Fu; Qing Zou; Lin Chen; Huayan Xu; Lingyi Wen; Linjun Xie; Jin Wu; Yingkun Guo

doi:10.1111/cen.14866

Evaluation of coronary microvascular dysfunction and risk factors in children and youth with Turner syndrome by magnetic resonance myocardial perfusion imaging

Clin Endocrinol (Oxf). 2023 Apr;98(4):578-586. doi: 10.1111/cen.14866. Epub 2022 Dec 27.

Authors

Wei Bai^{1

2}, Wei Huang^{1

2}, Rong Xu^{1

2}, Hang Fu^{1

2}, Qing Zou³, Lin Chen⁴, Huayan Xu^{1

2}, Lingyi Wen^{1

2}, Linjun Xie¹, Jin Wu⁵, Yingkun Guo^{1

2}

Affiliations

¹ Department of Radiology, State Key Laboratory of Biotherapy, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
² Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
³ Department of Radiology, Deyang People's Hospital, Deyang, Sichuan, China.
⁴ Department of Radiology, Su Zhou Municipal Hospital, Suzhou, Jiangsu, China.
⁵ Department of Pediatric Endocrinology and Metabolism, Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital of Sichuan University, Chengdu, China.

PMID: 36536468
DOI: 10.1111/cen.14866

Abstract

Objective: Turner syndrome (TS) has an increased predisposition to ischaemic heart disease and the status of coronary microcirculation in TS is largely unknown. This study aims to evaluate myocardial microvascular function in TS using first-pass magnetic resonance perfusion imaging and determine significant risk factors contributing to microvascular dysfunction in the early stage.

Design: Perspective cohort study.

Patients: The study cohort consisted of 67 children and youth with TS and 32 age- and gender-matched controls. Measurements Clinical characteristics, left ventricle (LV) volume and function and cardiovascular magnetic resonance-derived myocardial perfusion parameters were assessed. Univariable and multivariable linear regression analyses were performed to assess the potential risk factors for microvascular dysfunction.

Result: Microvascular perfusion decreased in TS in global and segmented myocardium as reflected in the lower upslope_cor and maximum signal intensity (MaxSI) of LV myocardium compared to controls. Multivariable linear regression analysis indicated that age (β = -0.107, 95% confidence interval [CI] = -0.201 to -0.013, p = .026) and being overweight/obese (β = -1.155, CI = -2.134 to -0.176, p = .021) were independent impact factors of microvascular dysfunction. Subgroup analysis showed the upslope_cor of older patients with TS decreased more significantly compared with that of normal controls. Upslope_cor and MaxSI were lower in overweight/obese patients with TS than in patients with normal body mass index (BMI) and controls.

Conclusion: Myocardial microvascular dysfunction can occur in children and youth patients with TS. Age and overweight/obesity were the independent risk factors of microvascular dysfunction, which imply the importance of lowering BMI for the prevention of coronary heart disease in young TS population.

Keywords: Turner syndrome; cardiac magnetic resonance first-pass perfusion imaging; myocardial microvascular function; paediatric.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Cohort Studies
Coronary Circulation
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Myocardial Ischemia*
Myocardial Perfusion Imaging* / methods
Obesity
Overweight
Predictive Value of Tests
Risk Factors
Turner Syndrome*

Associated data

ChiCTR/ChiCTR2100048689