Turk Kardiyol Dern Ars. 2012; 40(4): 337-346 | DOI: 10.5543/tkda.2012.49344

Echocardiographic evaluation of left ventricular function in normotansive obese children: a comparative analysis according to body mass index

Ayse Esin Kibar, Feyza Ayşenur Paç, Mehmet Burhan Oflaz, Şevket Ballı, İbrahim Ece
Turkiye Yuksek Ihtisas Education And Research Hospital, Department of Pediatric Cardiology, Ankara, Turkey

OBJECTIVES
The purpose of our study was to determine structural and functional changes on left ventricular function (LV) according to body mass index (BMI) in normotansive overweight and obese children.

STUDY DESIGN
Thirty normotansive overweight children (group 2; mean age: 13.2±2.1 years, BMI: 25-30 kg/m2), 30 obese children (group 3; mean age: 13.3±2.0 years, BMI ≥30 kg/m2), and 50 healthy controls (mean age: 13.2±1.8 years, BMI: 18-24.9 kg/m2) were included in this study. Continuous ambulatory pressure was monitored in the obese group, while standard and pulsed wave (PW) Doppler echocardiographic examinations were evaluated in all three study groups.

RESULTS
In overweight and obese children, left atrial volume, left atrial/aortic root diameter ratio, LV interventricular septum, LV posterior wall thickness, LV end-diastolic diameter and volume, and LV mass were significantly higher than those children in the control group (p<0.01). Blood pressure was within the normal range but was increased in the obese groups. Transmitral E/A and pulmonary vein (PV) systolic/diastolic velocity (S/D) ratios were decreased, but E-wave deceleration time, PVA velocities, and the end-diastolic distance from the mitral annulus to the LV apex were increased in both obese groups (p<0.05). BMI was significantly correlated with duration of obesity and LV mass (r=0.527, r=0.506, p<0.01, respectively). Significantly negative correlations were found between BMI, Mitral E/A, and PV S/D ratio (r=-0.230, r=-0.577, p<0.01, respectively).

CONCLUSION
Subclinical LV myocardial dysfunction was noted in obese subgroups. Determination of diastolic dysfunction by PV PW Doppler can be useful a pre-obese period.

Keywords: Child, echocardiography/methods; adolescent; obesity/complications/etiology/therapy; body weight; ventricular function, left; ventricular dysfunction, left

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