Association of Obesity and Hypertension With Left Ventricular Geometry and Function in Children and Adolescents

Abstract

Obesity, especially when complicated with hypertension, is associated with structural and functional cardiac changes. Recent studies have focused on the prognostic impact of the type of left ventricular (LV) geometric remodeling. This study looked at the prevalence and clinical correlates of LV geometric patterns and their relation to cardiac function in a sample of predominantly African‐American (AA) youth. Echocardiographic data was collected on 213 obese (BMI of 36.53 ± 0.53 kg/m2) and 130 normal‐weight subjects (BMI of 19.73 ± 0.21 kg/m2). The obese subjects had significantly higher LV mass index (LVMI; 49.6 ± 0.9 vs. 46.0 ± 1.0 g/m2.7, P = 0.01), relative wall thickness (RWT; 0.45 ± 0.00 vs. 0.40 ± 0.00, P < 0.001), left atrial (LA) index (33.2 ± 0.7 vs. 23.5 ± 0.6 ml/m, P < 0.001), more abnormal diastolic function by tissue Doppler E/Ea septal (7.5 ± 0.14 vs. 6.5 ± 0.12 ms, P < 0.001), E/Ea lateral (5.7 ± 0.12 vs. 4.8 ± 0.1 ms, P < 0.001), myocardial performance index (MPI; 0.43 ± 0.00 vs. 0.38 ± 0.00, P < 0.001), and Doppler mitral EA ratio (2.0 ± 0.04 vs. 2.4 ± 0.07, P < 0.001) but similar systolic function. Concentric remodeling (CR) was the most prevalent pattern noted in the obese group and concentric hypertrophy (CH) in the obese and hypertensive group. Obesity, hypertension, and CH were independent predictor of diastolic dysfunction. Systolic (SBP) and diastolic blood pressures (DBP) were the prime mediators for CH whereas obesity and diastolic blood pressure were predictors of CR. No significant association was observed between the geometric patterns and systolic function. Tracking LV hypertrophy (LVH) status and geometric adaptations in obesity may be prognostic tools for assessing cardiac risk and therapeutic end points with weight loss.

Evaluation of left ventricular function in overweight children and teenagers with arterial hypertension and white coat hypertension

“…In some studies, increased left ventricular mass in patients with WCH in comparison to healthy controls was reported [5]. In this study no significant differences of shortening and ejection fraction, describing left ventricular systolic function, between analysed groups were found, which is consistent with the majority of reports [13,14,[17][18][19].…”

Effects of Estrogen on Cardiovascular Injury in Ovariectomized Female DahlS.Z- Lepr fa /Lepr fa Rats as a New Animal Model of Metabolic Syndrome

“…35 Our observations that both the ratio of LV weight to tibial length (or echocardiography-derived LV mass) and relative wall thickness, as well as the expression of fetal-type cardiac genes, were significantly increased in Ovx-DS/obese rats indicate that these animals develop concentric LV hypertrophy in association with obesity and hypertension. None of these effects was influenced by treatment with E 2 .…”

Cardiac remodeling and diastolic dysfunction in DahlS.Z-Leprfa/Leprfa rats: a new animal model of metabolic syndrome

“…26 Obesity, especially when complicated with hypertension, is associated with changes in cardiac structure and function. 27 Concentric cardiac remodeling was the most prevalent pattern noted in obese subjects, with concentric hypertrophy being the most prevalent in obese subjects with hypertension. Furthermore, obesity, hypertension and concentric hypertrophy were found to be independent predictors of diastolic dysfunction.…”