Left and right ventricular function by echocardiography, tissue Doppler imaging, carotid intima-media thickness, and asymmetric dimethyl arginine levels in obese adolescents with metabolic syndrome

Abstract

PurposeThe aim of our study was to assess left ventricle and right ventricle systolic and diastolic functions in obese adolescents with metabolic syndrome using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotis intima-media thickness, and asymmetric dimethyl arginine levels.MethodsA total of 198 obese adolescents were enrolled in the study. The obese patients were divided into metabolic syndrome group and non-metabolic syndrome group. All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulsed, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness.ResultsObese adolescents were characterised by enlarged left end-diastolic, end-systolic and left atrial diameters, thicker left and right ventricular walls compared with non-obese adolescents. The metabolic syndrome group had normal left ventricle systolic function, impaired diastolic function, and altered global systolic and diastolic myocardial performance. In the metabolic syndrome obese group patients, left ventricle mass was found positively correlated with body mass index, waist and hip circumferences, diastolic blood pressure, age, and waist-to-hip circumference ratio. The carotid intima-media thickness was found positively correlated with waist and hip circumferences and total cholesterol levels. Asymmetric dimethyl arginine levels were found positively correlated with systolic blood pressure, waist-to-hip circumference ratio, and diastolic blood pressure.ConclusionsThe results of this study demonstrate that metabolic syndrome in adolescence is associated with significant changes in myocardial geometry and function. In addition, it has been associated with a high level of asymmetric dimethyl arginine concentration and thicker carotid intima-media thickness reflecting endothelial dysfunction.

Assessment of Right Ventricular Function by Speckle Tracking Echocardiography in Patients with Metabolic Syndrome

“…As for glucose and lipid regulation indicators, all metabolic parameters were significantly altered amongst the two groups of participants. This almost comes in complete agreement with the findings from the prospective study by Aslan et al, which demonstrated comparable results regarding plasma glucose, HDL, triglycerides, and cholesterol levels, but not LDL levels [26].…”

The effect of overweight/obesity on diastolic function in children and adolescents: A meta‐analysis

“…Forty‐three studies eligible for systematic review reported matching LVDF measures to those included in the meta‐analysis (Figure 4). 19–21,26,28,29,33,35,37,39,40,44,46,48–50,52–54,57–59,61–81 A full list of these results is given in Table S5.…”

“…Forty‐three studies eligible for systematic review reported matching LVDF measures to those included in the meta‐analysis (Figure 4 ). 19 , 20 , 21 , 26 , 28 , 29 , 33 , 35 , 37 , 39 , 40 , 44 , 46 , 48 , 49 , 50 , 52 , 53 , 54 , 57 , 58 , 59 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 A full list of these results is given in Table S5 .…”

Diverging trends for onset of acute myocardial infarction, heart failure, stroke and mortality in young males: role of changes in obesity and fitness

“…Notably, adjustment for BMI along with CRF attenuated the secular trends to a larger degree than did attenuation by CRF per se for AMI and HF. The contrasting trends for AMI and HF make sense considering the mounting evidence for a stronger link between obesity and cardiac remodelling compared with the link between obesity and AMI in younger people [15,16,39]. Moreover, it is clear that the impacts of some conventional risk factors on the decline are far greater for AMI than for HF [2], such that cholesterol and smoking are less associated with incident HF, whereas BMI [39] or triglycerides [14] are stronger risk factors for HF.…”