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Title in Portuguese: Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in young patients with congenital generalized lipodystrophy
Author: Ponte, Clarisse Mourão Melo
Fernandes, Virgínia Oliveira
Liberato, Christiane Bezerra Rocha
Montenegro, Ana Paula Dias Rangel
Batista, Lívia Aline
Gurgel, Maria Helane Costa
Karbage, Lia Beatriz de Azevedo
Vasconcelos, Izabella Tamira Galdino Farias
d’Alva, Catarina Brasil
Montenegro Júnior, Renan Magalhães
Keywords: Cardiopatias
Heart Diseases
Lipodistrofia Generalizada Congênita
Lipodystrophy, Congenital Generalized
Issue Date: Jul-2019
Publisher: Diabetology & Metabolic Syndrome
Citation: PONTE, Clarisse Mourão Melo et al. Association between cardiovascular autonomic neuropathy and left ventricular hypertrophy in young patients with congenital generalized lipodystrophy. Diabetol Metab Syndr, v. 11, n. 53, p. 1-10, jul. 2019.
Abstract: Background: Congenital generalized lipodystrophy (CGL) is a rare disorder characterized by the absence of subcutaneous adipose tissue, severe insulin resistance, diabetes mellitus, and cardiovascular complications, including cardiac autonomic neuropathy (CAN), left ventricular hypertrophy (LVH), and atherosclerosis. The present study aimed to access the association between CAN parameters and cardiovascular abnormalities in CGL patients. Methods: A cross-sectional study was conducted with 10 CGL patients and 20 healthy controls matched for age, sex, BMI, and pubertal stage. We evaluated clinical, laboratory, and cardiovascular parameters—left ventricular mass index (LVMI), interventricular septum thickness (IVS), systolic and diastolic function determined by two-dimensional transthoracic echocardiography; carotid intimal media thickness (cIMT); and cQT interval. Heart rate variability (HRV) was evaluated by spectral analysis components—high frequency (HF), low frequency (LF), very low frequency (VLF), LF/ HF ratio, and total amplitude spectrum (TAS)—and cardiovascular reflexes tests (postural hypotension test, respiratory, orthostatic and Valsalva coefficients). Results: In CGL group, four patients (40%) had LVH and diastolic dysfunction. HF component (parasympathetic control) was lower in LVH patients. CGL patients presented higher values of cIMT and cQT interval than heathy subjects. Inverse association between LVMI and LF (p = 0.011), IVS and LF (p = 0.007), and cIMT and leptin (p < 0.001) were observed, even after adjustments by HOMA-IR, A1c, and blood pressure. In CGL group, there were associations between LMVI and HF component (IC95%: − 1.000; − 00.553), LVMI and TAS (IC95%: − 1.000; − 0.012), and IVS and HF component (IC95%: − 1.000; − 0.371). Conclusion: The association between increased LV mass and parameters of HRV provides possible speculations about the involvement of CAN in the pathophysiology of the cardiac complications, including LVH, in patients with CGL.
metadata.dc.type: Artigo de Periódico
ISSN: 1758-5996
Appears in Collections:DMC - Artigos publicados em revistas científicas

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