Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T10:12:22.015Z Has data issue: false hasContentIssue false
  • English
  • Français

Does obesity influence ventricular repolarisation in children?

Published online by Cambridge University Press:  14 December 2020

Nihan Yıldırım Yıldız ,
Tayfun Uçar ,
Mehmet G. Ramoğlu Open the ORCID record for Mehmet G. Ramoğlu [Opens in a new window] ,
Merih Berberoğlu ,
Zeynep Şıklar ,
Ercan Tutar  and
Semra Atalay
Nihan Yıldırım Yıldız
Affiliation:
Ankara University, School of Medicine, Department of Pediatrics, Ankara, Turkey
Tayfun Uçar
Affiliation:
Ankara University, School of Medicine, Department of Pediatric Cardiology, Ankara, Turkey
Mehmet G. Ramoğlu*
Affiliation:
Ankara University, School of Medicine, Department of Pediatric Cardiology, Ankara, Turkey
Merih Berberoğlu
Affiliation:
Ankara University, School of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
Zeynep Şıklar
Affiliation:
Ankara University, School of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
Ercan Tutar
Affiliation:
Ankara University, School of Medicine, Department of Pediatric Cardiology, Ankara, Turkey
Semra Atalay
Affiliation:
Ankara University, School of Medicine, Department of Pediatric Cardiology, Ankara, Turkey
*
Author for correspondence: M. G. Ramoğlu, Ankara Üniversitesi Tıp Fakültesi Hastanesi, Tıp Fakültesi Caddesi. Cebeci/Çankaya, Ankara, Türkiye, 06590. Tel: +905327023611; Fax: +903123106371. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Ventricular repolarisation changes may lead to sudden cardiac death in obese individuals. We aimed to investigate the relationship between ventricular repolarisation changes, echocardiographic parameters, anthropometric measures, and metabolic syndrome laboratory parameters in obese children.

Methods:

The study involved 81 obese and 82 normal-weight healthy children with a mean age of 12.3 ± 2.7 years. Anthropometric measurements of participants were evaluated according to nomograms. Obese patients were subdivided into two groups; metabolic syndrome and non-metabolic syndrome obese. Fasting plasma glucose, fasting insulin, and lipid profile were measured. QT/QTc interval, QT/QTc dispersions were measured, and left ventricular systolic and diastolic measurements were performed.

Results:

Body weight, body mass index, relative body mass index, waist/hip circumference ratio, and systolic and diastolic blood pressures were significantly higher in obese children. QT and QTc dispersions were significantly higher in obese children and also obese children with metabolic syndrome had significantly higher QT and QTc dispersions compared to non-metabolic syndrome obese children (p < 0.001) and normal-weight healthy children (p < 0.001). Waist/hip circumference ratio, body mass index, and relative body mass index were the most important determinant of QT and QTc dispersions. Left ventricular wall thickness (left ventricular posterior wall thickness at end-diastole, left ventricular posterior wall thickness at end-systole, interventricular septal thickness at end-diastole) and left ventricular mass index were significantly higher and ejection fraction was lower in obese children. Left ventricular mass index and interventricular septal thickness at end-diastole were positively correlated with QT and QTc dispersions.

Conclusions:

Our study demonstrated that QT/ QTc interval prolongation and increase in QT and QTc dispersion on electrocardiogram may be found at an early age in obese children.

Keywords

ObesityQT dispersionQTc dispersionsystolic dysfunctionelectrocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 4 , April 2021 , pp. 568 - 576
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Gungor, NK. Overweight and obesity in children and adolescents. J Clin Res Pediatr Endocrinol 2014; 6: 129–143.CrossRefGoogle ScholarPubMed
Bereket, A, Atay, Z. Current status of childhood obesity and its associated morbidities in Turkey. J Clin Res Pediatr Endocrinol 2012; 4: 1–7.CrossRefGoogle ScholarPubMed
Maggio, AB, Martin, XE, Saunders Gasser, C, et al. Medical and non-medical complications among children and adolescents with excessive body weight. BMC Pediatr 2014; 14: 232.CrossRefGoogle ScholarPubMed
Poirier, P, Giles, TD, Bray, GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2006; 113: 898–918.CrossRefGoogle ScholarPubMed
Omran, J, Firwana, B, Koerber, S, Bostick, B, Alpert, MA. Effect of obesity and weight loss on ventricular repolarization: a systematic review and meta-analysis. Obes Rev 2016; 17: 520–530.CrossRefGoogle ScholarPubMed
van Noord, C, Eijgelsheim, M ,Stricker, BH. Drug- and non-drug-associated QT interval prolongation. Br J Clin Pharmacol 2010; 70: 16–23.CrossRefGoogle ScholarPubMed
Nigro, G, Russo, V, Di Salvo, G, et al. Increased heterogenity of ventricular repolarization in obese nonhypertensive children. PACE 2010; 33: 1533–1539.CrossRefGoogle ScholarPubMed
Zimmet, P, Alberti, G, Kaufman, F, et al. The metabolic syndrome in children and adolescents. Lancet 2007; 369: 2059–2061.CrossRefGoogle ScholarPubMed
H C. Investigation of hypertension in childhood. In: Denis Geary, FS (ed.) Comprehensive Pediatric Nephrology. Mosby Elsevier, Philadelphia, 2008, 645–665.Google Scholar
Neyzi, O, Furman, A, Bundak, R, Gunoz, H, Darendeliler, F, Bas, F. Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 2006; 95: 1635–1641.CrossRefGoogle ScholarPubMed
Hatipoglu, N, Ozturk, A, Mazicioglu, MM, Kurtoglu, S, Seyhan, S, Lokoglu, F. Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatri 2008; 167: 383–389.CrossRefGoogle ScholarPubMed
Hatipoglu, N, Mazicioglu, MM, Poyrazoglu, S, Borlu, A, Horoz, D, Kurtoglu, S. Waist circumference percentiles among Turkish children under the age of 6 years. Eur J Pediatr 2013; 172: 59–69.CrossRefGoogle ScholarPubMed
Kurtoglu, S, Hatipoglu, N, Mazicioglu, M, Kendirici, M, Keskin, M, Kondolot, M. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. J Clin Res Pediatr Endocrinol 2010; 2: 100–106.CrossRefGoogle ScholarPubMed
Bazett, HC. An analysis of the time-relations of electrocardiograms. Ann Noninvasive Electrocardiol 1997; 2: 177–194.CrossRefGoogle Scholar
Tutar, HE, Ocal, B, Imamoglu, A, Atalay, S. Dispersion of QT and QTc interval in healthy children, and effects of sinus arrhythmia on QT dispersion. Heart 1998; 80: 77–79.CrossRefGoogle ScholarPubMed
Devereux, RB, Reichek, N. Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method. Circulation 1977; 55: 613–618.CrossRefGoogle ScholarPubMed
Devereux, RB, Alonso, DR, Lutas, EM, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986; 57: 450–458.CrossRefGoogle ScholarPubMed
Malik, M, Batchvarov, VN. Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol 2000; 36: 1749–1766.CrossRefGoogle ScholarPubMed
Omran, J, Bostick, BP, Chan, AK, Alpert, MA. Obesity and Ventricular Repolarization: a Comprehensive Review. Prog Cardiovasc Dis 2018; 61: 124–135.CrossRefGoogle ScholarPubMed
Durante, A, Laforgia, PL, Aurelio, A, et al. Sudden cardiac death in the young: the bogeyman. Cardiol Young 2015; 25: 408–423.CrossRefGoogle Scholar
Samanta, R, Pouliopoulos, J, Thiagalingam, A, Kovoor, P. Role of adipose tissue in the pathogenesis of cardiac arrhythmias. Heart Rhythm 2016; 13: 311–320.CrossRefGoogle ScholarPubMed
Hua, N, Chen, Z, Phinikaridou, A, et al. The influence of pericardial fat upon left ventricular function in obese females: evidence of a site-specific effect. J Cardiovasc Magn Reson 2014; 16: 37.CrossRefGoogle ScholarPubMed
Jhuo, SJ, Hsieh, TJ, Tang, WH, et al. The association of the amounts of epicardial fat, P wave duration, and PR interval in electrocardiogram. J Electrocardiol 2018; 51: 645–651.CrossRefGoogle ScholarPubMed
Tam, WC, Lin, YK, Chan, WP, et al. Pericardial fat is associated with the risk of ventricular arrhythmia in Asian patients. Circ J 2016; 80: 1726–1733.CrossRefGoogle ScholarPubMed
Yilmaz, M, Kayancicek, H. Elevated LV Mass and LV Mass Index Sign on the Athlete’s ECG: Athletes’ Hearts are Prone to Ventricular Arrhythmia. J Clin Med 2018; 7: 122. doi: 10.3390/jcm7060122.CrossRefGoogle ScholarPubMed
Richardson, WJ, Clarke, SA, Quinn, TA, Holmes, JW. Physiological Implications of Myocardial Scar Structure. Compr Physiol 2015; 5: 1877–1909.CrossRefGoogle ScholarPubMed
D’Andrea, A, Morello, A, Iacono, AM, et al. Right ventricular changes in highly trained athletes: between physiology and pathophysiology. J Cardiovasc Echogr 2015; 25: 97–102.CrossRefGoogle ScholarPubMed
Omiya, K, Sekizuka, H, Kida, K, et al. Influence of gender and types of sports training on QT variables in young elite athletes. Eur J Sport Sci 2014; 14 (Suppl 1): S32–38.CrossRefGoogle ScholarPubMed
Khositseth, A, Nantarakchaikul, P, Kuptanon, T, Preutthipan, A. QT dispersion in childhood obstructive sleep apnoea syndrome. Cardiol Young 2011; 21: 130–135.CrossRefGoogle ScholarPubMed
Akyuz, A, Alpsoy, S, Akkoyun, DC, et al. Effect of overweight on P-wave and QT dispersions in childhood. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir 2013; 41: 515–521.Google ScholarPubMed
Mangner, N, Scheuermann, K, Winzer, E, et al. Childhood obesity: impact on cardiac geometry and function. JACC Cardiovasc Imag 2014; 7: 1198–1205.CrossRefGoogle ScholarPubMed
Patel, DA, Lavie, CJ, Artham, SM, Milani, RV, Cardenas, GA, Ventura, HO. Effects of left ventricular geometry and obesity on mortality in women with normal ejection fraction. Am J Cardiol 2014; 113: 877–880.CrossRefGoogle ScholarPubMed
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
Sanchez, AA, Levy, PT, Sekarski, TJ, et al. Markers of cardiovascular risk, insulin resistance, and ventricular dysfunction and remodeling in obese adolescents. J Pediatri 2015; 166: 660–665.CrossRefGoogle ScholarPubMed