Long-term home parenteral nutrition was associated with a significant increase in atrial septum thickness (+8.3 mm; p<0.01), consistent with lipomatous hypertrophy.
Observational (n=7)
Does long-term home parenteral nutrition increase the thickness of the cardiac interatrial septum in patients with severe short-bowel syndrome?
Long-term home parenteral nutrition in adults with short-bowel syndrome is associated with increased interatrial septum thickness, consistent with lipomatous hypertrophy.
Mean Difference: 8.3
p-value: p=<0.01
The aim of this study was to report unusual echocardiographic findings in patients on long-term home parenteral nutrition suggesting lipomatous hypertrophy of the cardiac interatrial septum. Seven patients (two women and five men, mean age 58 years) were prospectively evaluated by two-dimensional echocardiography before and during home parenteral nutrition for severe short-bowel syndrome. Parenteral caloric intake was 33 +/- 4 kcal/kg per day (mean +/- SD), with a mean supply of lipid emulsion of 1 g/kg per day. The first echocardiography, performed before initiation of home parenteral nutrition, was normal in the seven patients. The second echocardiography, performed 5 to 43 months (mean 20 months) later, revealed a significant increase of the thickness of the atrial septum in all patients (+8.3 +/- 3.6 mm; p less than 0.01), consistent with the diagnosis of lipomatous hypertrophy in four patients, and moderate fat accumulation in two others. The septum thickness measured after the nutritional support period was significantly correlated (p less than 0.05) with the total amount of nutrient and lipid infused. Cardiac nuclear magnetic resonance imaging was performed in two patients; it suggested the adipose nature of interatrial septum deposit. None of the patients developed clinical or electrocardiographic symptoms during the period of nutrition. We suggest that patients undergoing long-term home parenteral nutrition be screened for this new and unusual cardiac abnormality. Whether the latter might have clinical consequences in these patients remains to be determined.
Beau et al. (Fri,) conducted a observational in Severe short-bowel syndrome (n=7). Long-term home parenteral nutrition vs. Baseline (before initiation of home parenteral nutrition) was evaluated on Increase in thickness of the atrial septum (MD 8.3 mm, p=<0.01). Long-term home parenteral nutrition was associated with a significant increase in atrial septum thickness (+8.3 mm; p<0.01), consistent with lipomatous hypertrophy.