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The relevance of left ventricular functions to clinical and metabolic characteristics of prepubertal children with obesity

Part of: Echocardiography

Published online by Cambridge University Press:  29 September 2021

Shaimaa Rakha Open the ORCID record for Shaimaa Rakha [Opens in a new window] ,
Nanees Salem ,
Ahmed Abdel Khalek Abdel Razek ,
Donia M. Sobh ,
Farahat El-Moslemany  and
Hala Elmarsafawy Open the ORCID record for Hala Elmarsafawy [Opens in a new window]
Shaimaa Rakha*
Affiliation:
Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Nanees Salem
Affiliation:
Pediatric Endocrinology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Ahmed Abdel Khalek Abdel Razek
Affiliation:
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Donia M. Sobh
Affiliation:
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Farahat El-Moslemany
Affiliation:
Mansoura University Children Hospital, Mansoura University, Mansoura, Egypt
Hala Elmarsafawy
Affiliation:
Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt
*
Author for correspondence: S. Rakha, MD, MRCPCH, Assistant Professor of Pediatric Cardiology, Pediatric Cardiology Unit, Faculty of Medicine, Mansoura University, El Gomhouria St, Mansoura, Dakahlia Governorate35516, Egypt. Tel: +201030077567. E-mail: drshimaarhaka@mans.edu.eg
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Abstract

Background:

Paediatric obesity is a worldwide health burden, with growing evidence linking obesity to myocardial function impairments. The study aims to evaluate left ventricular functions among prepubertal obese children to obesity-related clinical and metabolic parameters.

Methods:

Between June 2019 and March 2020, 40 prepubertal children with obesity were recruited and compared to 40 healthy controls. Patients were assessed for body mass index z scores, waist circumference, body adiposity by bioimpedance analysis, and obesity-related laboratory tests, for example, serum chemerin. Left ventricular functions were assessed using variable echocardiographic modalities, such as M-mode, tissue Doppler, and two-dimensional speckle tracking.

Results:

Mean patients’ age was 9.25 ± 1.05 years. Left ventricular mass index, E/E’, and myocardial performance index were significantly increased in obese children than controls. Although M-mode-derived ejection fraction was comparable in both groups, two-dimensional speckle tracking-derived ejection fraction, global longitudinal strain, and global circumferential strain were significantly lower in cases than controls. Left ventricular mass index displayed a positive correlation with body mass index z score (p = 0.003), fat mass index (p = 0.037), and trunk fat mass (p = 0.021). Global longitudinal strain was negatively correlated with body mass index z score (p = 0.015) and fat mass index (p = 0.016). Serum chemerin was positively correlated with myocardial performance index (p = 0.01).

Conclusion:

Alterations of left ventricular myocardial functions in prepubertal obese children could be detected using different echocardiographic modalities. Chemerin, body mass index z score, fat mass index, and trunk fat mass were correlated with subclinical left ventricular myocardial dysfunction parameters before puberty. Our results reinforce early and strict management of childhood obesity upon detection of changes in anthropometric and body adiposity indices.

Keywords

Left ventricular Functionschildren with obesityclinicalmetabolic
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 8 , August 2022 , pp. 1246 - 1253
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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