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Novel Findings of Early Cardiac Dysfunction in Patients With Childhood-Onset Inflammatory Bowel Disease Using
Azusa Akiya1, Ken Takahashi2, Satoshi Akimoto2
1Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Insights
Patients with childhood-onset inflammatory bowel disease (IBD) show reduced heart muscle function. Layer-specific strain analysis can detect early cardiac issues in these individuals.
Area of Science:
- Cardiology
- Gastroenterology
- Pediatrics
Background:
- Inflammatory bowel disease (IBD) increases cardiovascular disease risk due to chronic inflammation and treatments.
- Childhood-onset IBD patients require monitoring for potential cardiac complications.
Purpose of the Study:
- To evaluate left ventricular function in pediatric IBD patients using layer-specific strain analysis.
- To identify early cardiac dysfunction indicators in childhood-onset IBD.
Main Methods:
- Included 47 ulcerative colitis (UC), 20 Crohn's disease (CD) patients, and 75 healthy controls.
- Assessed layer-specific global longitudinal strain and global circumferential strain (GCS) via echocardiography.
Main Results:
- Global longitudinal strain was reduced in all layers for UC and CD patients.
- Global circumferential strain (GCS) was lower in midmyocardial and epicardial layers in CD patients.
- Endocardial GCS correlated with left ventricular wall thickness in CD, suggesting compensatory changes.
Conclusions:
- Childhood-onset IBD is associated with decreased midmyocardial deformation.
- Layer-specific strain analysis is a valuable tool for detecting early cardiac dysfunction in IBD patients.
Background:
Patients with inflammatory bowel disease (IBD) are at a higher risk of developing cardiovascular diseases than healthy individuals, owing to persistent chronic inflammation and treatment effects. This study aimed to assess left ventricular function in patients with childhood-onset IBD using layer-specific strain analysis and to identify early indicators of cardiac dysfunction in them.
Methods:
A total of 47 patients with childhood-onset ulcerative colitis (UC), 20 patients with Crohn's disease (CD), and 75 age- and sex-matched healthy control subjects were included in this study. Conventional echocardiographic measurements of layer-specific (ie, endocardium, midmyocardium, and epicardium) global longitudinal strain and global circumferential strain (GCS) were evaluated in these participants.
Results:
Layer-specific strain analysis showed that global longitudinal strain was lower in all layers for the UC (P < .001) and CD (P < .001) groups, regardless of the age at onset, but that GCS was only lower in the midmyocardial (P = .032) and epicardial (P = .018) layers in the CD group than in the control group. Although the mean left ventricular wall thickness was not significantly different among the groups, it was significantly correlated with the GCS of the endocardial layer in the CD group (ρ= -0.615; P = .004), suggesting that thickening of the left ventricular wall occurred as a compensatory mechanism to maintain the endocardial strain in the CD group layer.
Conclusions:
Children and young adults with childhood-onset IBD displayed decreased midmyocardial deformation. Layer-specific strain could also be useful to identify indicators of cardiac dysfunction in patients with IBD.
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