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Relation of left atrial stiffness to insulin resistance in obese children: Doppler strain imaging study

Ragab A Mahfouz1, Abdelaziz Gomma1, Mohamed Goda1

  • 1Cardiology Department, Zagazig University Hospital, Zagazig, Egypt.

Echocardiography (Mount Kisco, N.Y.)
|November 4, 2014
PubMed

Insights

Obese children show altered cardiac strain measures, including lower peak systolic longitudinal strain (LAS) and higher stiffness index (LASt). The LASt measure is a strong predictor of insulin resistance in this population.

Area of Science:

  • Cardiology
  • Pediatrics
  • Metabolic Disorders

Background:

  • Childhood obesity is a growing concern with potential cardiovascular implications.
  • Insulin resistance is a common comorbidity in obese children.
  • Early detection of cardiac changes in obese children is crucial.

Purpose of the Study:

  • To evaluate cardiac strain measures, specifically peak systolic longitudinal strain (LAS) and stiffness index (LASt), in obese children.
  • To determine the relationship between these strain measures and insulin resistance in obese children.

Main Methods:

  • Eighty obese children and 60 nonobese controls underwent 2D speckle tracking imaging (2DSI) for LAS and LASt measurements.
  • Insulin resistance was assessed in the obese cohort.
  • Statistical analysis compared measures between groups and correlated LASt with insulin resistance.

Main Results:

  • Obese children exhibited significantly lower LAS (11.3 ± 2.2 vs. 38.2 ± 11.6) and higher LASt (1.12 ± 0.23 vs. 0.21 ± 0.11) compared to controls (P < 0.001).
  • LASt showed a strong correlation with insulin resistance (P < 0.0001).
  • An LASt cutoff of >1.0 predicted insulin resistance with 92% sensitivity and 86% specificity.

Conclusions:

  • Significant differences in LAS and LASt exist between obese and nonobese children, irrespective of normal ventricular function.
  • Cardiac strain measures, particularly LASt, are associated with insulin resistance in obese children.
  • LASt may serve as a valuable non-invasive biomarker for detecting insulin resistance in pediatric obesity.
Abstract

Keywords:
insulin resistanceleft atrial strainobese children

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