Impact of Obesity on Left Ventricular Geometry and Function in Pediatric Patients after Successful Aortic Coarctation Repair

Salvo, Giovanni Di; Gala, Simona; Castaldi, Biagio; Baldini, Luca; Limongelli, Giuseppe; D’Andrea, Antonello; Scognamiglio, Giancarlo; Sarubbi, Berardo; Caso, Pio; Pacileo, Giuseppe; Russo, Maria Giovanna; Calabrò, Raffaele

doi:10.1111/j.1540-8175.2011.01449.x

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…Shang et al reported increased LVM and decreased myocardial deformation in hypertensive CoA patients compared to healthy controls 23 . According to Salva et al, 24 2D‐STE analysis on obese and lean young patients revealed abnormal myocardial deformation properties along longitudinal, radial, and circumferential planes in the obese CoA patients. However, there was no obesity among our patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular functions by speckle‐tracking echocardiography in coarctation patients

et al. 2021

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Coarctation of the aorta (CoA) is a relatively common defect that occurs in the general population at a rate of 0.06%-0.08%, constituting 6%-8% of congenital heart disease. 1,2 CoA can be clinically asymptomatic, or it may present with a shock in infancy and may present with systemic hypertension, intracranial bleeding, and heart failure in adults. 3 Even if CoA is successfully treated, systemic hypertension can lead to the development of late complications such as left ventricular (LV) hypertrophy, heart failure, coronary artery disease, stroke, or sudden cardiac death. 4,5 Left ventricular ejection fraction (EF) is known not to be a sensitive marker for the detection of subclinical LV systolic dysfunction, and tissue Doppler imaging has its own limitations, including angle dependency. 6,7 Two-dimensional speckle-tracking echocardiography (2D-STE) is a novel used method in terms of showing regional subclinical myocardial functions. 8 The early detection of subclinical myocardial dysfunction in patients with CoA is essential for planning

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Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular functions by speckle‐tracking echocardiography in coarctation patients

et al. 2021

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“…Obesity leads to an increase in both total and central blood volume, resulting in elevated cardiac output (CO). This elevation in CO is primarily due to an increase in left ventricular (LV) stroke volume and a reduction in peripheral vascular resistances [19,23]. Moreover, severely obese individuals commonly exhibit heightened oxygen consumption [24].…”

Section: Impact On Cardiac Hemodynamicsmentioning

confidence: 99%

“…The impact of overweight and obesity is particularly critical in individuals with pre-existing heart conditions, such as children with CHD, as obesity s adverse effects on the cardiovascular system may exacerbate existing issues [18,19]. A recent review highlighted obesity and overweight prevalence in children with CHD reaching up to 22% and 36%, respectively [20].…”

Section: Introductionmentioning

confidence: 99%

Childhood Obesity and Congenital Heart Disease: A Lifelong Struggle

Di Salvo,

Cattapan,

Fumanelli

et al. 2023

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Congenital heart disease (CHD) affects approximately one in every one hundred infants worldwide, making it one of the most prevalent birth abnormalities globally. Despite advances in medical technology and treatment choices, CHD remains a significant health issue and necessitates specialized care throughout an individual′s life. Childhood obesity has emerged as a novel global epidemic, becoming a major public health issue, particularly in individuals with lifelong conditions such as CHD. Obesity has profound effects on cardiac hemodynamics and morphology, emphasizing the importance of addressing obesity as a significant risk factor for cardiovascular health. Obesity-induced alterations in cardiac function can have significant implications for cardiovascular health and may contribute to the increased risk of heart-related complications in obese individuals. Moreover, while diastolic dysfunction may be less apparent in obese children compared to adults, certain parameters do indicate changes in early left ventricular relaxation, suggesting that obesity can cause cardiac dysfunction even in pediatric populations. As most children with CHD now survive into adulthood, there is also concern about environmental and behavioral health risk factors in this particular patient group. Addressing obesity in individuals with CHD is essential to optimize their cardiovascular health and overall quality of life. This review aims to succinctly present the data on the impact of obesity on CHD and to enhance awareness of this perilous association among patients, families, and healthcare providers.

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“…5,6 Longitudinal strain has been validated to evaluate myocardial deformation in patients with CoA; circumferential strain and radial strain, on the other hand, have not shown so consistent results. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] However, data provided in the literature are still conflicting regarding the effect of successful CoA treatment on myocardial strain, and they show different results, depending on type of treatment, follow-up period, and strain evaluation technique (cardiac magnetic resonance, tissue Doppler, 2D speckle tracking, or 3D speckle tracking).…”

Section: Introductionmentioning

confidence: 99%

Myocardial strain pattern progress in patients with Coarctation of the Aorta undergoing aortic stenting

et al. 2020

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Background and Aim Ventricular function evaluation in coarctation of the aorta (CoA) has become more sophisticated and precise with speckle tracking, revealing subclinical changes. However, CoA stenting treatment effects in on myocardial strain are still controversial. This study aimed to estimate the extent to which changes in left ventricular global longitudinal strain (LV GLS) occur in patients with CoA who undergo stenting. Methods The study included 21 patients with CoA (median age: 15 years [8–39]) and 21 healthy individuals matched by age and gender. Clinical and echocardiographic evaluations were performed 1 day before, 6 months, and 1 year after stenting. Correlations between LV GLS and arm‐leg gradient, isthmus gradient on echocardiogram, age at intervention, left ventricular mass, and ejection fraction were tested. Results Before treatment, patients with CoA had lower LV GLS than the control group (−18.4% ± 1.96 vs −21.5% ± 1.37; P < .01), showing significant increase to −19.4% ± 2.1 at 6 months and −20.7% ± 2.19 at 1 year, P < .001. Only 28.5% (6 patients) had preserved GLS before treatment, improving to 80.9% (17 patients) in 1 year. The only variable correlated with low LV GLS values before treatment was age at intervention (Spearman's index = −0.571; P = .007). Conclusion Percutaneous therapy showed significant LV GLS improvement 12 months after aortic stenting. Older patients have lower GLS, suggesting that early intervention may have positive effects on preservation of LV systolic function.

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Impact of Obesity on Left Ventricular Geometry and Function in Pediatric Patients after Successful Aortic Coarctation Repair

Cited by 6 publications

References 24 publications

Evaluation of left ventricular functions by speckle‐tracking echocardiography in coarctation patients

Evaluation of left ventricular functions by speckle‐tracking echocardiography in coarctation patients

Childhood Obesity and Congenital Heart Disease: A Lifelong Struggle

Myocardial strain pattern progress in patients with Coarctation of the Aorta undergoing aortic stenting

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