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Subclinical left ventricular structural and functional alterations in children with obesity: is body mass or insulin resistance the main issue?

Published online by Cambridge University Press:  13 September 2024

Nazlican Civilibal Tang Open the ORCID record for Nazlican Civilibal Tang [Opens in a new window] ,
Kazim Oztarhan ,
Helen Bornaun  and
Ata Mert Civilibal
Nazlican Civilibal Tang*
Affiliation:
Department of Pediatrics Division of Rheumatology and Immunology, Washington University School of Medicine in Saint Louis, St Louis, MI, USA Department of Pediatrics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
Kazim Oztarhan
Affiliation:
Department of Pediatric Cardiology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
Helen Bornaun
Affiliation:
Department of Pediatrics, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
Ata Mert Civilibal
Affiliation:
School of Medicine, Bezmialem Vakif University, Istanbul, Turkey
*
Corresponding author: N. Civilibal Tang; Email: [email protected]
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Abstract

Objective:

Obesity is an independent risk factor for cardiovascular diseases. The study aims to assess the left ventricular structure and functions in children with obesity.

Methods:

This study included 29 patients with metabolic syndrome, 31 patients with obesity without metabolic syndrome, and 30 healthy children of similar age and gender. Demographic, anthropometric, and biochemical findings and left ventricular structure and functions evaluated by conventional pulsed wave Doppler and tissue Doppler echocardiography were compared.

Results:

The left ventricular mass index and relative wall thickness were significantly higher in children with obesity compared to controls. The mean left ventricular mass index of children with metabolic syndrome was also higher than for those without it. Most children with obesity had normal left ventricular geometry; concentric hypertrophy (27.6%) was more common in children with metabolic syndrome, and eccentric hypertrophy (25.7%) was more common in those without. The early to late diastolic mitral annular velocity ratios obtained with conventional pulsed wave Doppler echocardiography and tissue Doppler echocardiography (E/A and Em/Am, respectively) were lower in children with obesity than controls. In addition, the ratio obtained by tissue Doppler echocardiography was lower in children with metabolic syndrome than without. The homeostatic model assessment of insulin resistance, systolic blood pressure, and body mass index has been identified as independent factors for left ventricular structures and functions.

Conclusion:

Obesity causes subclinical left ventricular hypertrophy and diastolic dysfunction. Additional metabolic syndrome-related risks lead to further deterioration of cardiac morphology and functions.

Keywords

childrenleft ventricular mass indexleft ventricular dysfunctionmetabolic syndromeobesity
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 7
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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