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Left ventricular diastolic dysfunction without left ventricular hypertrophy in obese children and adolescents: a Tissue Doppler Imaging and Cardiac Troponin I Study

Published online by Cambridge University Press:  07 August 2017

Sonia A. El Saiedi ,
Marwa F. Mira ,
Sahar A. Sharaf ,
Maysoun M. Al Musaddar ,
Rania M. H. El Kaffas ,
Antoine F. AbdelMassih Open the ORCID record for Antoine F. AbdelMassih [Opens in a new window]  and
Ihab H. Y. Barsoum
Sonia A. El Saiedi
Affiliation:
Pediatric Cardiology Unit, Pediatrics’ Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
Marwa F. Mira
Affiliation:
Pediatric Endocrinology Unit, Pediatrics’ Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
Sahar A. Sharaf
Affiliation:
Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Maysoun M. Al Musaddar
Affiliation:
Pediatric Residency Program, Faculty of Medicine, Cairo University, Cairo, Egypt
Rania M. H. El Kaffas
Affiliation:
Pediatric Cardiology Unit, Pediatrics’ Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
Antoine F. AbdelMassih*
Affiliation:
Pediatric Cardiology Unit, Pediatrics’ Department, Specialized Children Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
Ihab H. Y. Barsoum
Affiliation:
October 6th University, Cairo, Egypt
*
Correspondence to: A. F. AbdelMassih, Pediatric Cardiology Unit, Pediatric Department, Pediatric Cardiology Division, Specialized Pediatric Hospital, Faculty of Medicine, Cairo University, Kasr Al Aini Street, Cairo, 12411, Egypt. Tel: +20 111 621 0610; Fax: 02-25323456; E-mail: antoine.abdelmassih@kasralainy.edu.eg
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Abstract

Background

Obesity increases the risk for various cardiovascular problems. Increase in body mass index is often an independent risk factor for the development of elevated blood pressure and clustering of various cardiovascular risk factors.

Objective

To determine early markers of left ventricular affection in obese patients before the appearance of left ventricular hypertrophy.

Methods

In this cross-sectional study, we evaluated 42 obese patients and 30 healthy controls. Their ages ranged from 6 to 19 years. Studied children were subjected to anthropometric, lipid profile, and serum Troponin I level measurements. Echocardiographic evaluation performed to assess the left ventricle included left ventricular dimension measurement using motion-mode echocardiography, based on which patients with left ventricular hypertrophy (10 patients) were eliminated, as well as conventional and tissue Doppler imaging.

Results

Tissue Doppler findings in the study groups showed that the ratio of transmitral early diastolic filling velocity to septal peak early diastolic myocardial velocity (E/e′) was significantly higher in cases compared with controls [6.9±1.4 versus 9.0±1.6, p (Pearson’s coefficient)=0.001, respectively]. The level of cardiac troponin I was significantly higher in cases compared with controls [0.14±0.39 ng/ml versus 0.01±0.01 ng/ml, p (Pearson’s coefficient)=0.047, respectively] and there was a significant correlation between troponin I and transmitral early diastolic filling velocity to septal peak early diastolic myocardial velocity ratio (E/e′) [R (correlation coefficient)=0.6].

Conclusion

Tissue Doppler Imaging and Troponin I evaluation proved useful tools to detect early affection of the left ventricle in obese patients even in the absence of left ventricular hypertrophy.

Keywords

Diastolic dysfunctionobesity cardiomyopathy in childrentissue Doppler imagingcardiac troponin Ileft ventricular hypertrophy
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 1 , January 2018 , pp. 76 - 84
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Copyright
© Cambridge University Press 2017 

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References

1. Roberto, CA, Swinburn, B, Hawkes, C, Huang, TTK, Costa, SA, Ashe, M, et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers and new thinking. Lancet 2015; 385: 2400–2409.CrossRefGoogle Scholar
2. Alpert, MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci 2001; 321: 225–236.CrossRefGoogle ScholarPubMed
3. Schwarz, EI, Schlatzer, C, Stehli, J, et al. Effect of CPAP withdrawal on myocardial perfusion in OSA: a randomized controlled trial. Respirology 2016; 21: 1126–1133.CrossRefGoogle ScholarPubMed
4. Nickola, MW, Wold, LE, Colligan, PB, Wang, G, Samson, WK, Ren, J. Leptin attenuates cardiac contraction in rat ventricular myocytes: role of NO. Hypertension 2000; 36: 501–505.CrossRefGoogle ScholarPubMed
5. Shibata, R, Ouchi, N, ITO, M, et al. Adiponectin-mediated modulation of hypertrophic signals in the heart. Nat Med 2004; 10: 1384–1389.CrossRefGoogle ScholarPubMed
6. Zhou, Y, Grayburn, P, Karim, A, et al. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci USA 2000; 97: 1784–1789.CrossRefGoogle ScholarPubMed
7. Messerli, F. Cardiovascular effects of obesity and hypertension. Lancet 1982; 319: 1165–1168.CrossRefGoogle Scholar
8. Koh, G. Obesity and left ventricular diastolic dysfunction. Korean J Obes 2016; 25: 129–130.CrossRefGoogle Scholar
9. Ghalli, I, Salah, N, Hussein, F, et al. Egyptian growth curves for infants, children and adolescents. In: Sartario A, Buckler JMH, Marazzi N, (eds). Crescere nel mondo. Ferring publisher, Chemin de la Vergognausaz, Switzerland, 2008.Google Scholar
10. Tanner, JM, Whitehouse, RH. Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Disease Childhood 1976; 51: 170–179.CrossRefGoogle ScholarPubMed
11. Cheitlin, MD, Armstrong, WF, Aurigemma, GP, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography. J Am Soc Echocardiogr 2003; 16: 1091–1110.Google ScholarPubMed
12. Khoury, PR, Mitsnefes, M, Daniels, SR, Kimball, TR. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 2009; 22: 709–714.CrossRefGoogle ScholarPubMed
13. Teichholz, LE, Kreulen, T, Herman, MV, Gorlin, R. Problems in echocardiographic volume determinations: echocardiography angiographic correlations in the presence or absence of asynergy. Am J Cardiol 1976; 37: 7e11.CrossRefGoogle ScholarPubMed
14. Hatle, L, Angelsen, BA, Tromsdal, A. Non-invasive estimation of pulmonary artery systolic pressure with Doppler ultrasound. Br Heart J 1981; 45: 157–165.CrossRefGoogle ScholarPubMed
15. Tei, C, Ling, LH, Hodge, DO, et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function–a study in normals and dilated cardiomyopathy. J Cardiol 1995; 26: 357–366.Google ScholarPubMed
16. Palmieri, V, Bella, J. Metabolic syndrome and left ventricular structure and functional abnormalities. Am J Hypertens 2006; 19: 206–207.CrossRefGoogle ScholarPubMed
17. Di Salvo, G, Pacileo, G, Del Giudice, EM, et al. Abnormal myocardial deformation properties in obese, non-hypertensive children: an ambulatory blood pressure monitoring, standard echocardiographic, and strain rate imaging study. Eur Heart J 2006; 27: 2689–2695.CrossRefGoogle ScholarPubMed
18. Klop, B, Elte, J, Cabezas, M. Dyslipidemia in obesity: mechanisms and potential targets. Nutrients 2013; 5: 1218–1240.CrossRefGoogle ScholarPubMed
19. Morris, EP, Sherwin, SL. Troponin-tropomyosin interactions. Fluorescence studies of the binding of troponin, troponin T and chymotryptic troponin T fragments to specifically labeled tropomyosin. Biochemistry 1984; 23: 2214–2220.CrossRefGoogle ScholarPubMed
20. Sou, SM, Puelacher, C, Twerenbold, R, et al. Direct comparison of cardiac troponin I and cardiac troponin T in the detection of exercise-induced myocardial ischemia. Clin Biochem 2016; 49: 421–432.CrossRefGoogle ScholarPubMed