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

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

Justine Paysal  1   2 , Etienne Merlin  3   4 , Emmanuelle Rochette  3   4 , Daniel Terral  3 , Stéphane Nottin  1
Affiliations

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

Justine Paysal et al. Front Pediatr. .

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.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Correlations between blood pressure, heart rate, and BMI z-score in AN patients (green circles), controls (gray triangles), and adolescents with obesity (orange circles). SBP, systolic blood pressure; DBP, diastolic blood pressure; MBP, mean blood pressure; HR, heart rate.
Figure 2
Figure 2
Correlation between fibrinogen and BMI z-score in AN patients (green circles), controls (gray triangles), and adolescents with obesity (orange circles).
Figure 3
Figure 3
Correlations between LV mass, epicardial fat thickness, and BMI z-score in AN patients (green circles), controls (gray triangles), and adolescents with obesity (orange circles).
Figure 4
Figure 4
Correlations between LV longitudinal and circumferential strains and BMI z-score in AN patients (green circles), controls (gray triangles), and adolescents with obesity (orange circles).
Figure 5
Figure 5
Correlations between twisting mechanics parameters and BMI z-score in AN patients (green circles), controls (gray triangles), and adolescents with obesity (orange circles).
See this image and copyright information in PMC

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