Left ventricular remodelling and vascular adaptive changes in adolescents with obesity

Kulkarni, Aparna; Gulesserian, Talin; Lorenzo, Jose Miguel Mateo D; Haroonian, Y.; Ngyuyen, M.; Lo, Yungtai; Wang, D.; Hsu, Daphne T.; Kaskel, Frederick J.; Mahgerefteh, Joseph

doi:10.1111/ijpo.12278

Cited by 13 publications

(15 citation statements)

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Previous studies have demonstrated MH is closely associated with obesity and target-organ damage in adolescents ( 33 – 35 ). Moreover, obesity and higher plasma glucose level in youth has been found to be linked to decreased myocardial deformation even in the absence of comorbidities in early stages ( 24 , 36 – 38 ). Therefore, it is reasonable to indicate that the observation of reduction of strain in asymptomatic young MH patients may contribute to the comprehensive effects of higher ambulatory pulse rate and glucose level as well as body weight.…”

Section: Discussionmentioning

confidence: 99%

Does Masked Hypertension Cause Early Left Ventricular Impairment in Youth?

et al. 2018

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Objectives: Masked hypertension (MH) is not uncommon in the youth and may increase risks of long-term cardiovascular impairment. However, little is known about the subclinical heart damage in this group of patients. Currently, 3-layer speckle tracking imaging based on two-dimensional echocardiography is feasible to detect the early signs of myocardial damage. We therefore aimed to investigate whether subtle changes of cardiac function occurred in the young MH patients by using advanced quantification with layer-specific speckle tracking.Methods: A total of 40 adolescents with MH (age 18 ± 3 years, 73% males) and 40 age-, gender-, race-, and height-matched normotensive volunteers were enrolled in our study. MH was defined as one or more of the ambulatory blood pressure (BP) parameters (24-h, daytime and night-time average BPs) higher than ≥ 95th percentile for gender and height according to the local reference. Both comprehensive two-dimensional echocardiography with layer-specific strain analysis and 24-h ambulatory BP monitoring were performed. Longitudinal strain and circumferential strain in endocardial, mid-myocardial, and epicardial layers were determined accordingly with the dedicated software (EchoPAC software version 201, GE Healthcare, Horten, Norway).Results: Compared with normotensive controls, youths with MH had higher ambulatory pulse rate and left ventricular mass index, and were more obese. Interestingly, similar ventricular volumes and ejection fraction were observed in the study groups, but further analysis with layer-specific strains revealed that endocardial and mid-myocardial longitudinal and circumferential mechanical function were decreased in the young MH subjects when compared to normotensive individuals (all p < 0.05). However, there were no difference regarding radial strain and apical rotation derived from traditional speckle tracking analysis.Conclusion: Subclinical change of LV mechanic function assessed by layer-specific speckle tracking is present in youth with MH despite considered as normal with conventional ways.Thus, MH in youth should be monitored closely instead of labeling as an entirely benign entity.

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“…Although ventricular weight is typically normalized to body weight in experimental research, overweight subjects have lower ventricular mass/body weight ratio, yielding an artificial difference as a result of the increased denominator in obesity ( 265 ). Recent observations showed that patients with obesity displayed a higher LV mass when appropriately indexed to height 2.7 ( 266 ). LV mass indexed to height 2.7 is more appropriately employed to avoid misleading predictions of CVD risk in obesity.…”

Section: Cardiac Remodeling In Obesitymentioning

confidence: 99%

Obesity cardiomyopathy: evidence, mechanisms, and therapeutic implications

Ren

Wang

et al. 2021

Physiological Reviews

230

120

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The prevalence of heart failure is on the rise and imposes a major health threat, in part, due to the rapidly increased prevalence of overweight and obesity. To this point, epidemiological, clinical and experimental evidence supports the existence of a unique disease entity termed "obesity cardiomyopathy", which develops independent of hypertension, coronary heart disease and other heart diseases. Our contemporary review evaluates the evidence for this pathological condition, examines putative responsible mechanisms, and discusses therapeutic options for this disorder. Clinical findings have consolidated the presence of left ventricular dysfunction in obesity. Experimental investigations have uncovered pathophysiological changes in myocardial structure and function in genetically-predisposed and diet-induced obesity. Indeed, contemporary evidence consolidates a wide array of cellular and molecular mechanisms underlying the etiology of obesity cardiomyopathy including adipose tissue dysfunction, systemic inflammation, metabolic disturbances (insulin resistance, abnormal glucose transport, spillover of free fatty acids, lipotoxicity, and amino acid derangement), altered intracellular especially mitochondrial Ca2+ homeostasis, oxidative stress, autophagy/mitophagy defect, myocardial fibrosis, dampened coronary flow reserve, coronary microvascular disease (microangiopathy), and endothelial impairment. Given the important role of obesity in the increased risk of heart failure, especially that with preserved systolic function and the recent rises in COVID-19-associated cardiovascular mortality, this review should provide compelling evidence for the presence of obesity cardiomyopathy, independent of various comorbid conditions, underlying mechanisms, and offer new insights into potential therapeutic approaches (pharmacological and lifestyle modification) for the clinical management of obesity cardiomyopathy.

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Left ventricular remodelling and vascular adaptive changes in adolescents with obesity

Abstract: 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.

Cited by 13 publications

References 29 publications

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

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

Does Masked Hypertension Cause Early Left Ventricular Impairment in Youth?

Obesity cardiomyopathy: evidence, mechanisms, and therapeutic implications

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