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Evaluation of the left ventricle longitudinal deformity using myocardial-tracking signals in severely obese adolescents

Published online by Cambridge University Press:  21 July 2015

Norma Balderrábano
Affiliation:
Cardiology DepartmentChildren Hospital of Mexico Federico Gómez, México, D.F., México
Blanca Del Rio*
Affiliation:
Allergy and Clinical Immunology, Children Hospital of Mexico Federico Gómez, México, D.F., México
Elsy Navarrete
Affiliation:
Allergy and Clinical Immunology, Children Hospital of Mexico Federico Gómez, México, D.F., México
Arturo Berber
Affiliation:
Allergy and Clinical Immunology, Children Hospital of Mexico Federico Gómez, México, D.F., México
Nancy Méndez
Affiliation:
Allergy and Clinical Immunology, Children Hospital of Mexico Federico Gómez, México, D.F., México
*
Correspondence to: B. Del Rio, Allergy and Clinical Immunology, Children Hospital of Mexico Federico Gómez, Calle Dr. Márquez 162, Delegación Cuauhtémoc, Colonia Doctores, 06720 Ciudad de México, Distrito Federal, Mexico. Tel: 01 55 5228 9917; Ext, 2150 or 2152, Fax: 01 55 5761 0947; E-mail: [email protected]

Abstract

Background

The global prevalence of obesity in school-age children and adolescents has increased in recent decades. Obesity modifies some aspects of the cardiovascular system in order to preserve the body homoeostasis. Echocardiography to study ventricular function plays an important role in the evaluation of pathological re-modelling associated with left ventricular dysfunction. The aim of this study was to evaluate the left ventricle function and structure with conventional echocardiography and to analyse the longitudinal deformity of the left ventricle using myocardial-tracking signals in a group of severely obese adolescents.

Methods and results

We carried out a descriptive cross-sectional study. We describe the evaluation of the left ventricle using conventional bi-dimensional echocardiography and the myocardial-tracking signals in severely obese adolescents. There were 34 severely obese adolescents included in our study; 52% had a left ventricular ejection fraction<55%, the left ventricular end-diastolic diameter was increased in 70.5% of patients, and 32.3% had an increase in left ventricular mass. On average, 78.9% had abnormal values of left ventricle longitudinal deformations. The number of segments affected per patient was, on average, 5.8, with the anterior apical segment being the most commonly affected. There was a decrease in global longitudinal deformity in 79.4% of the cases.

Conclusion

More than half of this group of asymptomatic severely obese adolescents showed abnormalities in left ventricular structure and function evaluated using traditional echocardiographic methods, but 100% of the cases showed abnormalities in longitudinal deformation in at least one of the 17 left ventricle segments evaluated using myocardial-tracking signals.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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References

1. Kimm, SY, Obarzanek, E. Childhood obesity: a new pandemic of the new millennium. Pediatrics 2002; 110: 10031007.Google Scholar
2. Jolliffe, D. Extent of overweight among US children and adolescents from 1971 to 2000. Int J Obes Relat Metab Disord 2004; 28: 49.Google Scholar
3. Ogden, CL, Flegal, KM, Carroll, MD, Johnson, CL. Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 2002; 288: 17281732.Google Scholar
4. Schaub, B, von Mutius, E. Obesity and asthma, what are the links? Curr Opin Allergy Clin Immunol 2005; 5: 185193.Google Scholar
5. Isomaa, B, Almgren, P, Tuomi, T, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 2001; 24: 683689.Google Scholar
6. Ahmad, QI, Ahmad, CB, Ahmad, SM. Childhood obesity. Indian J Endocrinol Metab 2010; 14: 1925.Google Scholar
7. Fagot-Campagna, A. Emergence of type 2 diabetes mellitus in children: epidemiological evidence. J Pediatr Endocrinol Metab 2000; 13 (Suppl 6): 13951402.Google Scholar
8. Freedman, DS, Dietz, WH, Srinivasan, SR, Berenson, GS. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999; 103 (Pt 1): 11751182.Google Scholar
9. Poirier, P, Giles, TD, Bray, GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol 2006; 26: 968976.Google Scholar
10. Goodfriend, TL, Calhoun, DA. Resistant hypertension, obesity, sleep apnea, and aldosterone: theory and therapy. Hypertension 2004; 43: 518524.Google Scholar
11. Edvardsen, T, Helle-Valle, T, Smiseth, OA. Systolic dysfunction in heart failure with normal ejection fraction: speckle-tracking echocardiography. Prog Cardiovasc Dis 2006; 49: 207214.Google Scholar
12. Troyo, P, Rosas-Peralta, M. Enfermedades cardiovasculares en la obesidad. In: Mendez Sanchez N, Uribe M (eds). Obesidad epidemiología, fisiopatología y manifestaciones clínicas. Manual Moderno, México, 2002: 75110.Google Scholar
13. Kampmann, C, Wiethoff, CM, Wenzel, A, et al. Normal values of M mode echocardiographic measurements of more than 2000 healthy infants and children in central Europe. Heart 2000; 83: 667672.Google Scholar
14. Vogel, M, Staller, W, Bühlmeyer, K. Left ventricular myocardial mass determined by cross-sectional echocardiography in normal newborns, infants, and children. Pediatr Cardiol 1991; 12: 143149.Google Scholar
15. Marcus, KA, Mavinkurve-Groothuis, AM, Barends, M, et al. Reference values for myocardial two-dimensional strain echocardiography in a healthy pediatric and young adult cohort. J Am Soc Echocardiogr 2011; 24: 625636.Google Scholar
16. Takigiku, K, Takeuchi, M, Izumi, C, et al. Normal range of left ventricular 2-dimensional strain: Japanese Ultrasound Speckle Tracking of the Left Ventricle (JUSTICE) study. Circ J 2012; 76: 26232632.Google Scholar
17. Mahoney, LT, Burns, TL, Stanford, W, et al. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996; 27: 277284.Google Scholar
18. Rocha, IE, Victor, EG, Braga, MC, Barbosa e Silva, O, Becker Mde, M. Echocardiography evaluation for asymptomatic patients with severe obesity. Arq Bras Cardiol 2007; 88: 5258.Google Scholar
19. Poirier, P, Giles, TD, Bray, GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol 2006; 26: 968976.Google Scholar
20. Garcia, J, Perez, E, Garcia, M. El ecocardiograma en el paciente con hipertensión arterial. In: Garcia M, Zamorano J, Garcia J. (eds). Ecocardiografía Básica. ENE Ediciones, Madrid, 2000: 161172.Google Scholar
21. Phan, TT, Shivu, GN, Abozguia, K, Gnanadevan, M, Ahmed, I, Frenneaux, M. Left ventricular torsion and strain patterns in heart failure with normal ejection fraction are similar to age-related changes. Eur J Echocardiogr 2009; 10: 793800.Google Scholar
22. Flu, WJ, van Kuijk, JP, Bax, JJ, Gorcsan, J 3rd, Poldermans, D. Three-dimensional speckle tracking echocardiography: a novel approach in the assessment of left ventricular volume and function? Eur Heart J 2009; 30: 23042307.Google Scholar
23. Dandel, M, Lehmkuhl, H, Knosalla, C, Suramelashvili, N, Hetzer, R. Strain and strain rate imaging by echocardiography – basic concepts and clinical applicability. Curr Cardiol Rev 2009; 5: 133148.Google Scholar
24. Sun, JP, Lee, AP, Wu, C, et al. Quantification of left ventricular regional myocardial function using two-dimensional speckle tracking echocardiography in healthy volunteers – a multi-center study. Int J Cardiol 2013; 167: 495501.Google Scholar
25. Hurlburt, HM, Aurigemma, GP, Hill, JC, et al. Direct ultrasound measurement of longitudinal, circumferential, and radial strain using 2-dimensional strain imaging in normal adults. Echocardiography 2007; 24: 723731.Google Scholar