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Echocardiographic evaluation of cardiac structure and function in obese Egyptian adolescents

Published online by Cambridge University Press:  02 December 2011

Hanan M. Kamal ,
Hoda A. Atwa ,
Omar M. Saleh  and
Faten A. Mohamed
Hanan M. Kamal*
Affiliation:
Department of Cardiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Hoda A. Atwa
Affiliation:
Department of Pediatrics, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Omar M. Saleh
Affiliation:
Department of Cardiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Faten A. Mohamed
Affiliation:
Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
*
Correspondence to: Dr H. M. Kamal, MD, Professor of Cardiology, Department of Cardiovascular Medicine, Faculty of Medicine – Suez Canal University, 41111 University Hospital Road, Ismailia, Egypt. Tel: +002 010 6329060; Fax: +002 064 3225753; E-mail: [email protected]
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Abstract

Objective

The objective of this study was to detect structural and functional changes in the left and right ventricles in obese Egyptian adolescents.

Methods and results

Anthropometric and echocardiographic parameters, including tissue Doppler imaging, were obtained from 70 obese adolescents with average body mass index of 34 plus or minus 3.8 and compared with 50 age- and sex-matched controls, with a body mass index of 21.6 plus or minus 1.9. Cardiac dimensions, stroke volume, left ventricular and right ventricular systolic and diastolic functions were evaluated. The obese group had a higher end-diastolic septal and posterior wall thickness and left ventricular mass index than the non-obese group. Body mass index, mid-arm and hip circumference values showed significant correlations with these echocardiographic variables. Systolic and diastolic functions of the left ventricle were normal in both groups, although stroke volume was high in the obese group. The right ventricle tissue Doppler parameters were similar in both groups. However, the S wave of the septal/lateral tricuspid valve annulus was reduced in the obese group, but not to the level reflecting systolic dysfunction. This was inversely correlated with hip, waist, and mid-arm circumference. Stepwise multiple regression analysis showed that the mid-arm and hip circumference followed by the body mass index are significant predictors of these early cardiac abnormalities.

Conclusion

Left ventricular hypertrophy is present in obese children, although both systolic and diastolic functions are normal. Tissue Doppler imaging revealed a minor, but still significant, reduction in the right ventricular systolic function. Mid-arm and hip circumference are predictors of left ventricular hypertrophy.

Keywords

Adolescentobesityechocardiographycardiac abnormalities
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 4 , August 2012 , pp. 410 - 416
Copyright
Copyright © Cambridge University Press 2012

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References

1. Klein, S, Burke, LE, Bray, GA, et al. American Heart Association Council on nutrition, physical activity, and metabolism; American College of Cardiology Foundation. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on nutrition, physical activity, and metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2004; 110: 2952–2967.CrossRefGoogle Scholar
2. Mokdad, AH, Serdula, MK, Dietz, WH, Bowman, BA, Marks, JS, Koplan, JP. The spread of the obesity epidemic in the United States, 1991–1998. JAMA 1999; 282: 1519–1522.CrossRefGoogle ScholarPubMed
3. Hedley, AA, Ogden, CL, Johnson, CL, Carroll, MD, Curtin, LR, Flegal, KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 2004; 291: 2847–2850.CrossRefGoogle ScholarPubMed
4. de Simone, G, Daniels, SR, Devereux, RB, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 1992; 20: 1251–1260.CrossRefGoogle ScholarPubMed
5. Yoshinaga, M, Yuasa, Y, Hatano, H, et al. Effect of total adipose weight and systemic hypertension on left-ventricular mass in children. Am J Cardiol 1995; 76: 785–787.CrossRefGoogle ScholarPubMed
6. Daniels, SR, Kimball, TR, Morrison, JA, Khoury, P, Witt, S, Meyer, RA. Effect of lean body mass, fat mass, blood pressure, and sexual maturation on left ventricular mass in children and adolescents. Statistical, biological, and clinical significance. Circulation 1995; 92: 3249–3254.CrossRefGoogle ScholarPubMed
7. Fernandez, JR, Redden, DT, Pietrobelli, A, Allison, DB. Waist circumference percentiles in nationally representative sample of African-American, European-American, and Mexican-American children and adolescents. J Pediatr 2004; 145: 439–444.CrossRefGoogle ScholarPubMed
8. Sardinha, LB, Going, SB, Teixeira, PJ, Lohman, TG. Receiver operating characteristic analysis of body mass index, triceps skin fold, and arm girth for obesity screening in children and adolescents. Am J Clin Nutr 1999; 70: 1090–1095.CrossRefGoogle Scholar
9. Schiller, NB, Shah, PM, Crawford, M, et al. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiogr 1989; 2: 358–367.CrossRefGoogle ScholarPubMed
10. Devereux, RB, Lutas, EM, Casale, PN, et al. Standardization of M-mode echocardiographic left ventricular anatomic measurements. J Am Coll Cardiol 1984; 4: 1222–1230.CrossRefGoogle ScholarPubMed
11. Daniels, SR, Kimball, TR, Morrison, JA, Khoury, P, Meyer, RA. Indexing left ventricular mass to account for differences in body size in children and adolescents without cardiovascular disease. Am J Cardiol 1995; 76: 699–701.CrossRefGoogle ScholarPubMed
12. Tei, C, Ling, LH, Hodge, DO, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function – a study in normals and dilated cardiomyopathy. J Cardiol 1995; 26: 357–366.Google ScholarPubMed
13. Williams, CL, Hayman, LL, Daniels, SR, et al. Cardiovascular health in childhood: a statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 2002; 106: 143–160.CrossRefGoogle Scholar
14. Li, X, Li, S, Ulusoy, E, Chen, W, Srinivasan, SR, Berenson, GS. Childhood adiposity as a predictor of cardiac mass in adulthood: the Bogalusa heart study. Circulation 2004; 110: 3488–3492.CrossRefGoogle ScholarPubMed
15. Chinali, M, de Simone, G, Roman, MJ, et al. Impact of obesity on cardiac geometry and function in a population of adolescents: the strong heart study. J Am Coll Cardiol 2006; 47: 2267–2273.CrossRefGoogle Scholar
16. Milani, RV, Lavie, CJ, Ventura, HO, Kurtz, J, Messerli, FH. Effect of left ventricular remodeling on mortality in 35,602 patients with normal systolic function. J Am Coll Cardiol 2003; 52nd Annual Scientific Session of the American-College-of-Cardiology, Chicago, Illinois, 459A.CrossRefGoogle Scholar
17. Khositseth, A, Suthutvoravut, U, Chongviriyaphan, N. Left ventricular mass and geometry in obese children. Asian J Clin Nutr 2009; 1: 58–64.CrossRefGoogle Scholar
18. Forbes, GB. Nutrition and growth. J Pediatr 1977; 91: 40–42.CrossRefGoogle ScholarPubMed
19. Rowland, TW. Effect of obesity on cardiac function in children and adolescents: a review. J Sports Sci Med 2007; 6: 319–326.Google ScholarPubMed
20. Wong, CY, O'Moore-Sullivan, T, Leano, R, Byrne, N, Eller, E, Marwick, TH. Alterations of left ventricular myocardial characteristics associated with obesity. Circulation 2004; 110: 3081–3087.CrossRefGoogle ScholarPubMed
21. Hill, DJ, Milner, DG. Insulin as a growth factor. Pediatr Res 1985; 19: 879–886.CrossRefGoogle ScholarPubMed
22. Putte-Katier, NV, Rooman, RP, Haas, L, et al. Early cardiac abnormalities in obese children: importance of obesity per se versus associated cardiovascular risk factors. Pediatr Res 2008; 64: 205–209.CrossRefGoogle ScholarPubMed
23. Pascual, M, Pascual, DA, Soria, F, et al. Effects of isolated obesity on systolic and diastolic left ventricular function. Heart 2003; 89: 1152–1156.CrossRefGoogle ScholarPubMed
24. Rowland, T, Dunbar, NS. Effects of obesity on cardiac function in adolescent females. Am J Lifestyle Med 2007; 1: 283–288.CrossRefGoogle Scholar
25. Nagueh, SF, Bachinski, LL, Meyer, D, et al. Tissue Doppler imaging consistently detects myocardial abnormalities in patients with hypertrophic cardiomyopathy and provides a novel means for an early diagnosis before and independently of hypertrophy. Circulation 2001; 104: 128–130.CrossRefGoogle ScholarPubMed
26. Harada, K, Orino, T, Takada, G. Body mass index can predict left ventricular diastolic filling in asymptomatic obese children. Pediatr Cardiol 2001; 22: 273–278.CrossRefGoogle ScholarPubMed
27. Kinik, ST, Varan, B, Yildirim, SV, Tokel, K. The effect of obesity on echocardiographic and metabolic parameters in childhood. J Pediatr Endocrinol Metab 2006; 19: 1007–1014.CrossRefGoogle ScholarPubMed
28. Zeybek, C, Aktuglu-Zeybek, C, Onal, H, Altay, S, Erdem, A, Celebi, A. Right ventricular subclinical diastolic dysfunction in obese children: the effect of weight reduction with a low-carbohydrate diet. Pediatr Cardiol 2009; 30: 946–953.CrossRefGoogle ScholarPubMed
29. Peterson, LP, Waggoner, AD, Kenneth, B, et al. Alterations in left ventricular structure and function in young healthy obese women. Assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol 2004; 43: 1399–1404.CrossRefGoogle ScholarPubMed