The impact of lower body compression garment on left ventricular rotational mechanics in patients with lipedema—Insights from the three‐dimensional speckle tracking echocardiographic MAGYAR‐Path Study

Abstract

Summary Lipedema is a lymphedema‐masquerading symmetrical, bilateral and disproportional obesity. Its conservative maintenance treatment comprises the use of flat‐knitted compression pantyhoses. Lipedema is known to be associated with left ventricular morphological and functional alterations. The present study aimed to assess the effects of graduated compression stockings on left ventricular (LV) rotational mechanics measured by three‐dimensional speckle‐tracking echocardiography (3DSTE) in lipedema patients. The present study comprised twenty lipedema patients (mean age: 45.8 ± 11.0 years, all females) undergoing 3DSTE who were also compared to 51 age‐ and gender‐matched healthy controls (mean age: 39.8 ± 14.1 years, all females). 3DSTE analysis was performed at rest, and subsequent to 1 hour application of compression class 2 made‐to‐measure flat‐knitted pantyhose. Six lipedema patients showed significant LV rotational abnormalities. Of the remaining fourteen lipedema patients LV basal rotation rotation showed significant reduction, while LV apical rotation showed significant increase with unchanged LV twist after a 60‐minute use of compression garment. Significant changes in LV rotational mechanics could be detected among 14 women with lipedema after the use of compression garment however six probands have special LV rotational abnormalities at baseline and/or after compression.

Are increased left ventricular strains compensatory effects in lipedema? Detailed analysis from the three‐dimensional speckle‐tracking echocardiographic MAGYAR‐Path Study

“…4 At this moment, only a limited number of clinical studies are available regarding lipedema-associated cardiovascular alterations. 6,7,19 Although routine echocardiography shows no significant alterations, recent developments in imaging techniques generated new methodologies, including 3DSTE, allowing detailed analysis for deeper insights into the heart mechanics. [6][7][8][9] Not only LV rotational abnormalities and changes in contractility can be quantified with 3DSTE, but alterations of dimension and function of atria and valvular annuli can be characterized non-invasively in greater details.…”

“…6,7,19 Although routine echocardiography shows no significant alterations, recent developments in imaging techniques generated new methodologies, including 3DSTE, allowing detailed analysis for deeper insights into the heart mechanics. [6][7][8][9] Not only LV rotational abnormalities and changes in contractility can be quantified with 3DSTE, but alterations of dimension and function of atria and valvular annuli can be characterized non-invasively in greater details. [6][7][8][9] The result of the present study could be partially explained in the context of recent findings.…”

“…The study protocol was the same as reported in previous studies. 6,7 First, 2D Doppler echocardiography was performed with 3DSTE in all patients with lipedema. Then, MCSs were put on and worn for…”

“…echocardiography (3DSTE). 6,7 This relatively newly developed noninvasive imaging technique provides quantitative assessment of myocardial contractility by strain variables from acquired 3D echocardiographic datasets. 8,9 The present study was designed to determine whether lipedema is associated with 3DSTE-derived LV deformation abnormalities, and to assess the effects of wearing MCS for 1 hour.…”

Mitral annular dimensions and function in certain disorders and their relationship to left ventricular function

“…echocardiography and consecutively 3DSTE. After the echocardiographic measurements, the patients donned their MCSs and applied them for 60 minutes (26). Postprocedural echocardiography was scheduled at the end of the 60-min MCS application before the patients took off the MCSs.…”