P2.11 ASSESSING VENTRICULAR-VASCULAR INTERACTIONS IN GIRLS WITH TURNER SYNDROME: A PILOT STUDY

Abstract

Objectives: Women with Turner Syndrome (TS) have increased incidence of cardiovascular disease, thought to be related to a clustering of risk factors including insulin resistance, hypertension, obesity and dyslipidemia. The aim of this study was to non-invasively determine and compare ventricular and vascular function in girls with TS to healthy controls. Methods: Ventricular assessment included standard echocardiographic M-mode and 2-D volumetric techniques, plus Doppler tissue velocities. Vascular assessment included applanation tonometry, carotid ultrasound, echo-Doppler of the aorta and brachial artery reactivity. Between groups comparisons were performed using parametric methods with p-values>0.05 considered significant. Results: Seventeen girls with TS without significant congenital heart disease and 17 healthy age-matched girls (8–18 years) were studied. Heights and weights were similar, but BMI increased in TS, suggesting increased weight-for-height, as expected. Resting heart rates and peripheral and derived central systolic and diastolic blood pressures were increased in TS. Carotid distensibility was decreased in TS, but derived augmentation index, carotid-femoral pulse wave velocity, aortic dimensions and echo-Doppler measures of aortic stiffness and vascular impedance, and flow-mediated dilation assessment of endothelial function, were all similar. Left ventricular systolic function by M-mode and two-dimensional volumetric assessment and myocardial performance index by Doppler were similar, but increased E/E’ ratios suggestive of increased ventricular filling pressures were found in TS. Conclusions: Elevated resting heart rates and blood pressures, decreased carotid distensibility and suggestion of increased ventricular filling pressures in girls with TS, may be playing a role in future increased risk of cardiovascular disease and warrant further investigation.