Evaluation of Atrial Electromechanical Delay in Children with Obesity

Abstract

Background and Objective: Childhood obesity is one of the worldwide health problems with an increasing prevalence and accompanied by severe morbidity and mortality. It is a serious predisposing risk factor especially for the development of cardiovascular diseases and arrhythmias. Electromechanical delay (EMD) is known to be a predictor for the development of atrial fibrillation (AF). Our study aims to investigate whether EMD, which is a predictor of AF, prolongs in obese children or not. Material and Methods: The study included 59 obese patients aged between 8–18 years and 38 healthy patients as the control group with a similar age and gender. All the individuals underwent transthoracic echo and tissue Doppler echocardiography. Systolic and diastolic left ventricular (LV) functions, inter- and intra-atrial electromechanical delay were measured by tissue Doppler imaging (TDI) and conventional echocardiography. Results: Obese patients had significantly lengthened P-wave on surface ECG to the beginning of the late diastolic wave (PA) lateral, PA septum, intra- and inter-atrial electromechanical delays when compared with the control group (p < 0.001, p = 0.001, p < 0.001 and p < 0.001, respectively) Inter-atrial EMD and intra-atrial EMD correlated positively with body mass index (BMI) values (r = 0.484, p < 0.001 and r = 0.376, p = 0.001; respectively) BMI was significantly related with inter-atrial EMD (β = 0.473, p < 0.001) However, there was no relationship between inter-atrial EMD and serum glucose and platelet count. Conclusion: In our study, we declared that electromechanical delay was increased in obese children when compared to the control group and intra- and inter-atrial electromechanical delay was in correlation with body mass index. Furthermore, we discovered that BMI is an independent predictor of the inter-atrial EMD in obese children.

Effects of metformin on epicardial adipose tissue and atrial electromechanical delay of obese children with insulin resistance

“…It has been demonstrated that atrial electromechanical delay predicts arrhythmias in studies conducted with adults and children. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Although its mechanism has not been completely understood in obesity, pro-inflammatory cytokines like interleukin-1, interleukin-6 and tumour necrosis factor-α which are secreted from visceral and epicardial adipose tissue may cause atrial electromechanical delay by causing inflammation in atrial tissue. 29 A decrease in visceral and epicardial adipose tissue may also cause a decrease in electromechanical delay by further reducing existing inflammation.…”

“…[8][9][10][11] It has been known that electromechanical delay predicts atrial fibrillation and it has been demonstrated that obese children have electromechanical delay. 12 However, the effects of metformin on electromechanical delay in obese children with insulin resistance have not been known.…”

Relação entre o Tecido Adiposo Epicárdico e Resistência à Insulina em Crianças Obesa

“…Electromechanical conduction prolongation has been shown to be prone to atrial fibrillation. 31 IR, which is frequently associated with obesity, has an effect on atrial functions due to existing subclinical inflammation. In our study, both intra-and inter-atrial conduction time was found to be higher in obese children with insulin resistance, according to the literature, compared to the non-IR group.…”

Serum amphiregulin and cerebellin 1 levels in primary hypertension patients

“…For all measurements, the average of at least three cardiac cycles was evaluated. For the conventional Doppler echocardiographic examinations and M-mode measurements, the European Society of Echocardiography guideline criteria were used [17].…”