Assessing pre-clinical ventricular dysfunction in obese children and adolescents: the value of speckle tracking imaging

Barbosa, José Augusto A; Mota, Cleonice de Carvalho Coelho; Silva, Ana Cristina Simões e; Nunes, Maria do Carmo Pereira; Barbosa, Márcia M.

doi:10.1093/ehjci/jes294

Cited by 71 publications

(108 citation statements)

References 43 publications

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“…Standard echocardiography of obese pediatric patients with no comorbidities revealed a larger left atrial diameter, increased LV mass and the absence of systolic left ventricular dysfunction (Table 1), which is in agreement with previous studies [10,23], Data reported by Di Salvo et al show left and right atrial dysfunction in obese pediatric patients. Moreover, the present study demonstrates a reduction in right atrial strain and SR in obese children and adolescents in comparison to lean controls [14].…”

Section: Discussionsupporting

confidence: 91%

“…In a previous study analyzing right ventricular function, our research group found an increase in strain and SR in obese pediatric patients and speculated that the hyperdynamic state found in obesity due to an increase in preload may influence RV strain and SR [10]. It is possible that decreased RV strain and SR is only detected later on in the obesity process, when the incipient RV systolic dysfunction overcomes the increase in preload and after load [6].…”

Section: Discussionmentioning

confidence: 86%

“…Cardiovascular complications associated with obesity contribute to high rates of morbidity and mortality. Structural and functional alterations in the heart, such as left ventricular hypertrophy, diastolic/systolic dysfunction and atrial enlargement, are well established in adult and pediatric patients with obesity [5][6][7][8][9][10]. Left atrial dysfunction with left ventricular diastolic dysfunction in subjects with preserved systolic function is well established in patients with hypertension [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Right Atrial Function in Obese Pediatric Patients

Barbosa¹,

Damião²,

P³

et al. 2013

J Obes Weight Loss Ther

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IntroductionObesity has become an epidemic in both developed and developing countries. Statistics from the United States of America reveal a 32.2% rate of obesity among adult men and 25.5% among adult women [1]. It is estimated that Five to 10 million adult individuals in the United States alone have severe obesity (body mass index ≥ 40 kg/m 2 ) [2]. In developing countries, the prevalence of obesity has reached more than 20% of the population. Reports on the pediatric population (children and adolescents aged two to 19 years) reveal that 11.9% are at or above the 97 th percentile of the body mass index (BMI) for age, 16.9% are at or above the 95 th percentile and 31.7% are at or above the 85 th percentile [3]. Ten percent of children starting school in the United Kingdom are already obese [4]. Cardiovascular complications associated with obesity contribute to high rates of morbidity and mortality. Structural and functional alterations in the heart, such as left ventricular hypertrophy, diastolic/systolic dysfunction and atrial enlargement, are well established in adult and pediatric patients with obesity [5][6][7][8][9][10]. Left atrial dysfunction with left ventricular diastolic dysfunction in subjects with preserved systolic function is well established in patients with hypertension [11,12]. There is strong evidence that left atrial enlargement and dysfunction are associated with an increase in morbidity and mortality rates in patients with cardiovascular disease and present clinical relevance with respect to the rate of long-term events, survival and the risk of developing atrial fibrillation [13]. Using Doppler-derived strain and strain rate (SR) MethodsObese pediatric patients six to 18 years of age with a BMI above the 95 th percentile were prospectively recruited from the nutrition clinic of a university hospital (Universidade Federal de Minas Gerais) in Belo Horizonte, Brazil. The control group was formed by children aged six to 18 years with a BMI below the 85 th percentile recruited from the general pediatrics clinic of the same institution. Patients with a history of hypertension, diabetes mellitus, endocrinological disorders, hereditary or inflammatory systemic diseases, sleep apnea (according to parents' information) and athletes were excluded in both groups. This study received approval from the Human Research Ethics Committee of the institution and written informed consent was obtained from all participants and/or parents. The participants were weighed in light clothing without shoes using a Welmy ® scale with a capacity of 300 Kg and accuracy of 100 g. Height was measured with a stadiometer (accuracy of 0.5 cm). BMI was calculated using the conventional formula of weight in kilograms divided by the square of height in AbstractBackground : Left atrial enlargement and right and left ventricular dysfunction have been described in obese Patients. A number of studies have also described atrial dysfunction in obese children and adolescents.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of Right Atrial Function in Obese Pediatric Patients

Barbosa¹,

Damião²,

P³

et al. 2013

J Obes Weight Loss Ther

View full text Add to dashboard Cite

show abstract

“…Two-dimensional (2D) speckle tracking echocardiography (STE) is a more effective method for objectively evaluating both the systolic and diastolic functions of the myocardium in detail [9][10][11]. STE assessment might be useful for identifying patients with subclinical LV dysfunction when the LV ejection fraction (LVEF) is normal on conventional echocardiography [12,13]. The aim of this study was to evaluate LV dysfunction in the early period in patients with PCOS at risk of developing LV dysfunction using STE.…”

Section: Introductionmentioning

confidence: 99%

The importance of speckle tracking echocardiography in the early detection of left ventricular dysfunction in patients with polycystic ovary syndrome

Demirelli¹,

Değirmenci²,

Ermis³

et al. 2015

Biomol Biomed

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Polycystic ovary syndrome (PCOS) is characterized by hormonal and metabolic abnormalities and is thought to increase a risk for cardiovascular diseases. In this study we use speckle tracking echocardiography (STE) to evaluate left ventricular (LV) dysfunction in the early period of the disease. We enrolled 31 patients with PCOS and 32 healthy volunteers as a control group. The participants' ages ranged between 18 and 40 years. PCOS was diagnosed according to the Rotterdam criteria. LV strain (LS) and strain rate (SR) were evaluated using apical two-chamber (2C), three-chamber (3C), and four-chamber (4C) imaging. Global LS and SR were calculated as average of three apical views. The waist-to-hip ratio, homeostasis model assessment-insulin resistance (HOMA-IR), and fasting insulin and triglyceride levels were higher in the PCOS group than in the controls (p = 0.001, p = 0.001, p = 0.001, and p = 0.005, respectively). In the PCOS group, the mitral A wave, deceleration time (DT), and isovolumetric relaxation time (IVRT) were significantly higher than in the controls (all p < 0.05). The LV global longitudinal strain (GLS) and global longitudinal SR systolic (GLSRS) were significantly lower in the PCOS patient group (both p = 0.001). There were strong negative correlations between GLS and both fasting insulin (r = −0.64) and DT (r = -0.62) (both p < 0.05). The study demonstrated that PCOS patients had decreased LV function using STE. Therefore, STE imaging appears to be useful for the early detection of subclinical LV dysfunction in patients with PCOS.

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“…Obesity and cardiac involvement has been reported frequently in the literature, but analysis of regional myocardial function in children by two-dimensional (2D) speckle tracking echocardiography (STE) is rarely documented (4)(5)(6)(7)(8).…”

mentioning

confidence: 99%

Effect of Obesity on Left Ventricular Longitudinal Myocardial Strain by Speckle Tracking Echocardiography in Children and Adolescents

et al. 2015

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Background: Impaired subclinical ventricular function may contribute to the risk of cardiovascular disease in obesity. Aims: The aim of this study was to determine the influence of obesity on left ventricular (LV) longitudinal myocardial function in normotensive obese children using two-dimensional (2D) speckle tracking echocardiography (STE). Study Design: Case-control study. Methods: Sixty normotensive obese children aged 10-16 years (mean age, 13.9±2.3 years) were compared with 50 normal-weight controls. Obese participants had a body mass index (BMI)≥95 th percentile. Regional strain/strain rate (SR) values were compared with left ventricular (LV) parameters. The correlation was studied by linear regression analysis. Results: Obese subjects exhibited a significantly higher LV end-diastolic diameter, left atrium/aortic diameter ratio, and LV mass/index when compared to controls (p<0.001). Left ventricular ejection fraction and regional systolic myocardial velocities were similar in the obese and control groups. By 2D STE, regional strain of both the septal wall (average strain:

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Assessing pre-clinical ventricular dysfunction in obese children and adolescents: the value of speckle tracking imaging

Abstract: Although EF was not different between the two groups, LV 2D speckle tracking longitudinal strain was lower in the obese group, even in the absence of other comorbidities, indicating that obesity effects on LV function is an early finding in obesity.

Cited by 71 publications

References 43 publications

Analysis of Right Atrial Function in Obese Pediatric Patients

Analysis of Right Atrial Function in Obese Pediatric Patients

The importance of speckle tracking echocardiography in the early detection of left ventricular dysfunction in patients with polycystic ovary syndrome

Effect of Obesity on Left Ventricular Longitudinal Myocardial Strain by Speckle Tracking Echocardiography in Children and Adolescents

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