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Body mass index can predict left ventricular diastolic filling in asymptomatic obese children
1Department of Pediatrics, Akita University School of Medicine, 1-1-1 Hondo, Akita 010, Japan.
Insights
Elevated body mass index in children is linked to abnormal left ventricular diastolic filling, particularly affecting pulmonary venous flow patterns. This suggests body mass index is a predictor of diastolic dysfunction in pediatric obesity.
Area of Science:
- Cardiology
- Pediatric Health
- Echocardiography
Background:
- Obesity is a growing concern in pediatric populations.
- Left ventricular diastolic function can be impacted by metabolic changes associated with obesity.
- Early detection of cardiac changes in obese children is crucial.
Purpose of the Study:
- To investigate the relationship between body mass index (BMI) and left ventricular diastolic function in obese children.
- To assess pulmonary venous and mitral valve flow velocity patterns using Doppler echocardiography.
- To determine if BMI correlates with abnormalities in diastolic filling.
Main Methods:
- Pulse Doppler echocardiography was used to measure pulmonary venous and mitral valve flow velocities in 21 obese children and age-matched controls.
- Key indexes included peak systolic (S) and diastolic (D) velocities, D/S ratio for pulmonary veins, and peak early diastolic (E) and atrial contraction (A) velocities, E/A ratio for mitral inflow.
- Obesity was quantified as percentage above ideal BMI.
Main Results:
- Obese children showed reduced peak diastolic (D) velocity and D/S ratio in pulmonary venous flow, indicating impaired early diastolic filling.
- Pulmonary venous flow patterns became abnormal (peak D < peak S) in obese patients with >70% excess BMI.
- Mitral flow patterns also suggested decreased early diastolic filling, but these indices did not significantly correlate with BMI percentage.
Conclusions:
- Body mass index is a significant predictor of left ventricular diastolic filling abnormalities in children, as assessed by pulmonary venous flow patterns.
- Obesity-induced changes in diastolic function may manifest earlier in pulmonary venous flow than in mitral inflow.
- These findings highlight the importance of echocardiographic assessment of diastolic function in obese children.
Abstract:
To examine the effects of body mass index on left ventricular diastolic function, flow velocity patterns of the pulmonary vein and mitral valve were measured by pulse Doppler echocardiography in 21 asymptomatic obese children and were compared with those of an age-matched control population. The degree of obesity was calculated as (actual body mass index/ideal body mass index -1) x 100. The pulmonary venous flow indexes were peak systolic (S) and diastolic (D) velocities and peak D/S. The mitral inflow indexes were peak velocities of early diastole (E) and atrial contraction (A) and peak E/A. The pulmonary venous flow velocity pattern in obese patients was characterized by unchanged peak S, decreases in peak D (43 +/- 7 vs 51 +/- 8, p < 0.01) and peak D/S (0.98 +/- 0.19 vs 1.29 +/- 0.20, p < 0.01), suggesting the reduction in the early diastolic filling. The peak D/S decreased significantly with an increase in the percentage body mass index (r = -0.84, p < 0.01). In contrast to the pulmonary venous flow pattern (peak D > peak S) as seen in normal controls, all of the obese patients with > 70% over body mass index had abnormal pulmonary venous flow velocity patterns (peak D < peak S). The mitral flow velocity pattern in obese patients was also characterized by a decrease in early diastolic filling. However, these indices did not correlate with an increase in the percentage over body mass index. This study suggests that body mass index predicts the abnormality of left ventricular diastolic filling assessed by pulmonary venous flow patterns.