Alterations of left ventricular myocardial strain in obese children
Fabien Labombarda1, Eva Zangl, Audrey Emmanuelle Dugue
1Department of Cardiology, CHU de Caen, Avenue cote de nacre, Caen, France.
Insights
Childhood obesity is linked to reduced heart muscle function, specifically in longitudinal and circumferential strain. These changes in left ventricular (LV) strain may impact the long-term health of obese children.
Area of Science:
- Cardiology
- Pediatric Health
- Obesity Research
Background:
- Childhood obesity is a growing concern with potential cardiovascular implications.
- Myocardial structural changes may lead to mechanical consequences in obese children.
- Early detection of cardiac alterations is crucial for managing long-term health outcomes.
Purpose of the Study:
- To investigate myocardial structural changes in children with isolated obesity using 2D speckle echocardiography.
- To examine the relationship between obesity, inflammation, insulin resistance, and physical capacity in obese children.
- To identify early signs of cardiac dysfunction in pediatric obesity.
Main Methods:
- Prospective echocardiography and 2D strain analysis were performed on 32 obese children and 32 age/sex-matched controls.
- Assessed body mass index (BMI) Z-score, C-reactive protein, HOMA-IR, and metabolic stress test in obese children.
- Multivariate analysis adjusted for age, mean arterial pressure, and left ventricular (LV) mass.
Main Results:
- Obese children exhibited significantly lower longitudinal and circumferential LV strain compared to controls.
- Longitudinal strain correlated with insulin resistance (HOMA-IR) and exercise capacity.
- BMI Z-score remained an independent predictor of reduced longitudinal and circumferential strain after adjustments.
Conclusions:
- Childhood obesity is associated with early alterations in LV longitudinal and circumferential strain.
- These findings suggest potential clinical implications for the management and follow-up of obese children.
- Further research is warranted to understand the long-term impact of these cardiac changes.
Aims:
Obesity may have implications in the myocardial structural change, which may contribute to mechanical consequences. Using 2D speckle echocardiography, we looked for myocardial changes and investigated their relation to obesity, inflammation, insulin resistance and physical capacity in children with isolated obesity.
Methods And Results:
Standard echocardiography and 2D strain were prospectively performed in obese children and compared them with age- and sex-matched controls. Z-score body mass index (BMI Z-score), ultra-sensitive C reactive protein, indices of insulin resistance (HOMA-IR) and metabolic stress test were assessed in obese children. Thirty-two consecutive obese patients [age: 12.8 (8-17) years; 15 males; BMI Z-score: 5.8 [2.05-8.6)] were compared with 32 controls. Longitudinal strain and circumferential strain were significantly lower in the obese group (respectively -18.0 ± 2.4% vs. -20.6 ± 2.5%; P = 0.0001 and -18.2 ± 3.5% vs. -20.1 ± 2.3%; P = 0.013), while radial strain did not differ. Longitudinal strain was correlated with HOMA-IR (Pearson's rho = -0.39) and with the exercise capacity (Pearson's rho = 0.62). In the multivariate analysis, after adjusting for age, the mean arterial pressure and left ventricular (LV) mass, the BMI Z-score remained independently related to the longitudinal and circumferential strain.
Conclusion:
Childhood obesity may be associated with an early alteration of the longitudinal and circumferential LV strain. These findings have potentially significant clinical implications for the outcomes and follow-up of obese children meriting further studies.
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