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Lipomatous Hypertrophy of the Cardiac Interatrial Septum: An Unusual Complication in Long‐Term Home Parenteral Nutrition in Adult Patients
Author(s) -
Beau P.,
Michel P.,
Coisne D.,
MorichauBeauchant M.
Publication year - 1991
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607191015006659
Subject(s) - parenteral nutrition , medicine , interatrial septum , complication , gastroenterology , enteral administration , cardiology , surgery , atrial fibrillation , left atrium
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 < 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 < 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. ( Journal of Parenteral and Enteral Nutrition 15:659–662, 1991)