Impact of BMI z-score on left ventricular mechanics in adolescent girls

Justine Paysal; Etienne Merlin; Emmanuelle Rochette; Daniel Terral; Stéphane Nottin

doi:10.3389/fped.2023.1165851

Impact of BMI z-score on left ventricular mechanics in adolescent girls

Front Pediatr. 2023 Jul 26:11:1165851. doi: 10.3389/fped.2023.1165851. eCollection 2023.

Authors

Justine Paysal^{1

2}, Etienne Merlin^{3

4}, Emmanuelle Rochette^{3

4}, Daniel Terral³, Stéphane Nottin¹

Affiliations

¹ LaPEC UPR 4278, Laboratory of Cardiovascular Physiology, Avignon University, Avignon, France.
² Néonatologie et Réanimation Pédiatrique, CHU Clermont-Ferrand, Clermont-Ferrand, France.
³ CHU Clermont-Ferrand, Department of Pediatrics, Clermont-Ferrand, France.
⁴ INSERM, CIC 1405, Unité CRECHE, Université Clermont Auvergne, Clermont-Ferrand, France.

Abstract

Background: Adolescent weight disorders ranging from anorexia nervosa (AN) to obesity (OB) can impact the heart by causing opposite alterations in its morphology, suggesting a direct impact of body mass index (BMI) on the heart. Cardiac function is relatively preserved as assessed by standard echocardiography. However, few studies have used 2D speckle-tracking echocardiography (2D-STE), which can detect subtle alterations of left ventricular (LV) function by evaluating deformations. This study aimed to assess the link between the BMI z-score of adolescent girls and myocardial function.

Methods: Ninety-one adolescent girls comprising 26 AN patients (age 14.6 ± 1.9 years), 28 OB patients (age 13.2 ± 1.4 years), and 37 controls (age 14.0 ± 2.0 years) underwent 2D-STE to assess LV morphology and myocardial global and regional deformations.

Results: The BMI z-score of our population ranged from -4.6 to 5.2. LV morphological remodeling was significantly and positively correlated with the BMI z-score (R² = 0.456, p < 0.0001 for LV mass). Global longitudinal strain (LS) and regional LS recorded at the mid and apical levels were significantly correlated with the BMI z-score (R² = 0.196, p = 0.0001 and R² = 0.274, p < 0.0001, respectively, for apical and medial LS). Circumferential strains and twisting mechanics were not correlated with the BMI z-score. Fibrinogen and systolic blood pressure were the main variables explaining the alteration of LS.

Conclusion: We observed that the BMI z-score had an impact on LV mechanics, especially on medial and apical LS. Neither circumferential nor twisting mechanics were altered by the BMI z-score in adolescent girls.

Keywords: BMI z-score; adolescent; anorexia nervosa; myocardial strains; obesity; speckle-tracking echocardiography.

Grants and funding

This work was supported by the Platform 3A, funded by the European Regional Development Fund, the French Ministry of Research, Higher Education and Innovation, the Provence-Alpes-Côte-d'Azur region, the Departmental Council of Vaucluse, and the Urban Community of Avignon.