Early myocardial functional abnormalities in primary dyslipidemia: clinical and echocardiographic observations in young children from a highly consanguineous population

Abstract

Background: Dyslipidemia is a major health problem among children and adolescents worldwide due to its significant association with cardiovascular disease. Primary dyslipidemias are commonly familial syndromes that can be completely asymptomatic.Purpose: Apart from the risk of coronary artery disease (CAD), limited data are currently available on the direct effects of dyslipidemia on myocardial function in children. Methods:We recruited 25 childrenwith primary dyslipidemia(14 with isolated hypercholesterolemia, 4 with isolated hypertriglyceridemia, and 7 with combined dyslipidemia).Relevant clinical manifestations and laboratory and radiological investigations were evaluated. Pulsed-wave Doppler and tissue Doppler imaging echocardiography were performed of all recruited patients and the results were compared with those of 15 age-and sex-matched healthy children. Results:The median age of the dyslipidemic children was 8years (range 1.5-16years). A family history was documented in 13 cases (52%), while 18 (72%) had consanguineous parents.None of the dyslipidemic children had a personal history or clinical manifestations of CAD. In contrast, echocardiographic findings differed in several diastolic function parameters of both right and left ventricles in dyslipidemic children compared to controls. Based on normalized Z-scores, aortic valve narrowing was detected in 7 patients (28%), while narrowing of the aortic sinus (sinus of Valsalva) was detected in 15patients (60%). Conclusion:Different types of primary dyslipidemia produce functional myocardial abnormalities early in childhood. Biochemical and echocardiographic screening of high-risk children is advised to minimize the incidence of serious cardiovascular complications.

Addressing comprehensive complexities a striking familial hypercholesterolemia case study

“…Noninvasive imaging plays a pivotal role in evaluating cardiac and aortic involvement. Techniques encompass echocardiography, magnetic resonance imaging (MRI), and CT scans, each offering detailed insights into the heart, aorta, and coronary arteries [ 8 ]. Echocardiography gauges valvular function and blood flow, while CT scans detect coronary calcification indicative of atherosclerosis.…”

Early echocardiographic screening for subclinical myocardial dysfunction in children and adolescents with dyslipidemia: why and when?

“…A previous study highlighted the need for echocardiographic evaluation upon identifying impaired diastolic function of both ventricles and narrowing of the aortic valve and sinus of Valsalva. 1) The authors arrived at this conclusion by measuring the M-mode, twodimensional, pulse-wave, and color Doppler blood flow velocity measurements of the heart valves. In addition, functional parameters, including ejection fraction, peak systolic and early/late diastolic velocities, and global myocardial performance index, were measured.…”

“…As the prevalence of obesity and metabolic syndrome in children increases, the progression of CVD may occur at a younger age. In the issue of Clinical and Experimental Pediatrics, El-Koofy et al [ 1 ] presented an association between primary dyslipidemia and myocardial dysfunction in early childhood. Primary dyslipidemia is mainly familial and manifests in childhood, and disease severity is usually worse than that of secondary dyslipidemia.…”

“…A previous study highlighted the need for echocardiographic evaluation upon identifying impaired diastolic function of both ventricles and narrowing of the aortic valve and sinus of Valsalva [ 1 ]. The authors arrived at this conclusion by measuring the M-mode, 2-dimensional, pulse-wave, and color Doppler blood flow velocity measurements of the heart valves.…”

PREVENTIVE EFFECTS OF FIGS POWDER & GARLIC POWDER IN MALE ALBINO RATS WITH INDUCED DYSLIPIDEMIA

“…Different complications can develop due to dyslipidemia, like diabetes mellitus, gall stones, biliary obstruction, fatty liver, cardiac diseases like ischemic heart diseases, etc. (El-Koofy et al, 2022). Statin drugs are commonly used all over the world for the management of dyslipidemia (Alam et al, 2021) .…”