Left ventricular remodelling and vascular adaptive changes in adolescents with obesity.

BACKGROUND: The aim of this study was to determine the effects of obesity on myocardial mechanics and ventriculo-arterial coupling (V-A) in children.

METHODS: Strain parameters, stroke volume, arterial elastance, left ventricular (LV) elastance and V-A were compared after adjusting for age and hypertension and after multivariate sub-group analysis between patients with and without obesity.

RESULTS: Among 123 retrospectively enrolled subjects, 6-21 years age, 79.7% males, 52% were obese. Median (range) Body Mass Index Z score was +2.35 (1.67-4.43) for obese and +0.68 (-2.48-1.63) for non-obese. Subjects with obesity had higher LV mass indexed2.7 (LVMI2.7 ) compared with non-obese (P < 0.001). Lower global longitudinal strain (GLS) (P = 0.012), global circumferential strain (GCS) (P = 0.004), average longitudinal strain rate (P = 0.002) and average circumferential strain rate (P < 0.001) were seen in subjects with obesity; no difference was noted in arterial elastance, LV end systolic elastance and V-A. Increased LVMI2.7 , decreased GLS, GCS, average longitudinal strain rate, average circumferential strain rate and maintained V-A were noted in the multivariate analysis between subgroups.

CONCLUSIONS: Obesity causes alterations in myocardial mechanics with preserved V-A in children. These findings may aid intervention in preventing the long-term cadiovascular effects of obesity.