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Left and right ventricular function by echocardiography, tissue Doppler imaging, carotid intima-media thickness, and asymmetric dimethyl arginine levels in obese adolescents with metabolic syndrome

Published online by Cambridge University Press:  28 January 2019

Eyup Aslan ,
Ahmet Sert ,
Muammer Buyukinan ,
Mustafa Ozgur Pirgon ,
Huseyin Kurku ,
Hakan Yilmaz  and
Dursun Odabas
Eyup Aslan*
Affiliation:
Department of Pediatric Cardiology, Denizli State Hospital, Denizli, Turkey
Ahmet Sert
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Selcuk University, Konya, Turkey
Muammer Buyukinan
Affiliation:
Department of Pediatric Endocrinology and Diabetes, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
Mustafa Ozgur Pirgon
Affiliation:
Department of Pediatric Endocrinology and Diabetes, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
Huseyin Kurku
Affiliation:
Department of Biochemistry, University of Health Sciences, Konya Training and Research Hospital, Konya, Turkey
Hakan Yilmaz
Affiliation:
Department of Radiology, Agri State Hospital, Agri, Turkey
Dursun Odabas
Affiliation:
Department of Pediatric Cardiology, Faculty of Medicine, Necmettin Erbakan University Konya, Konya, Turkey
*
Author for correspondence: E. Aslan, Department of Pediatric Cardiology, Denizli State Hospital, Denizli, Turkey. Tel: +902582639311; Fax: +902582619206; E-mail: eyupaslan6@gmail.com
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Abstract

Purpose

The aim of our study was to assess left ventricle and right ventricle systolic and diastolic functions in obese adolescents with metabolic syndrome using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotis intima-media thickness, and asymmetric dimethyl arginine levels.

Methods

A total of 198 obese adolescents were enrolled in the study. The obese patients were divided into metabolic syndrome group and non-metabolic syndrome group. All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulsed, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness.

Results

Obese adolescents were characterised by enlarged left end-diastolic, end-systolic and left atrial diameters, thicker left and right ventricular walls compared with non-obese adolescents. The metabolic syndrome group had normal left ventricle systolic function, impaired diastolic function, and altered global systolic and diastolic myocardial performance. In the metabolic syndrome obese group patients, left ventricle mass was found positively correlated with body mass index, waist and hip circumferences, diastolic blood pressure, age, and waist-to-hip circumference ratio. The carotid intima-media thickness was found positively correlated with waist and hip circumferences and total cholesterol levels. Asymmetric dimethyl arginine levels were found positively correlated with systolic blood pressure, waist-to-hip circumference ratio, and diastolic blood pressure.

Conclusions

The results of this study demonstrate that metabolic syndrome in adolescence is associated with significant changes in myocardial geometry and function. In addition, it has been associated with a high level of asymmetric dimethyl arginine concentration and thicker carotid intima-media thickness reflecting endothelial dysfunction.

Keywords

Adolescentasymmetric dimethyl argininecardiovascular diseasecarotid intima-media thicknessmetabolic syndrome
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 3 , March 2019 , pp. 310 - 318
Copyright
© Cambridge University Press 2019 

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Footnotes

Cite this article: Aslan E, Sert A, Buyukinan M, Pirgon MO, Kurku H, Yilmaz H, Odabas D (2019) Left and right ventricular function by echocardiography, tissue Doppler imaging, carotid intima-media thickness, and asymmetric dimethyl arginine levels in obese adolescents with metabolic syndrome. Cardiology in the Young29: 310–318. doi: 10.1017/S1047951118002329

References

1. Ayalon, N, Gopal, DM, Mooney, DM, et al. Preclinical left ventricular diastolic dysfunction in metabolic syndrome. Am J Cardiol 2014; 114: 838–842.Google Scholar
2. Tadic, M, Ivanovic, B, Grozdic, I. Metabolic syndrome impacts the right ventricle: true or false? Echocardiography 2011; 28: 530–538.Google Scholar
3. Kawada, T, Andou, T, Fukumitsu, M. Metabolic syndrome showed significant relationship with carotid atherosclerosis. Heart Vessels 2016; 31: 664–670.Google Scholar
4. De Gennaro Colonna, V, Bianchi, M, Pascale, V, et al. Asymmetric dimethylarginine (ADMA): an endogenous inhibitor of nitric oxide synthase and a novel cardiovascular risk molecule. Med Sci Monit 2009; 15: 91–101.Google Scholar
5. Bouras, G, Deftereos, S, Tousoulis, D, et al. Asymmetric Dimethylarginine (ADMA): a promising biomarker for cardiovascular disease? Curr Top Med Chem 2013; 13: 180–200.Google Scholar
6. Sen, N, Poyraz, F, Tavil, Y, et al. Carotid intima-media thickness in patients with cardiac syndrome X and its association with high circulating levels of asymmetric dimethylarginine. Atherosclerosis 2009; 204: 82–85.Google Scholar
7. Alberti, KG, Eckel, RH, Grundy, SM, et al. International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; International Association for the Study of Obesity. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640–1645.Google Scholar
8. Ozturk, A, Mazicioglu, MM, Hatipoglu, N, et al. Reference body mass index curves for Turkish children 6 to 18 years of age. J Pediatr Endocrinol Metab 2008; 21: 827–836.Google Scholar
9. Matthews, DR, Hosker, JP, Rudenski, AS, Naylor, BA, Treacher, DF, Turner, RC. Homeostasis model assessment: insulin resistance and betacell function from fasting plasma glucose and insulin concentrations in men. Diabetologia 1985; 28: 412–429.Google Scholar
10. Chen, XM, Hu, CP, Li, YJ, Jiang, JL. Cardiovascular risk in autoimmune disorders: role of asymmetric dimethylarginine. Eur J Pharmacol 2012; 696: 5–11.Google Scholar
11. Sahn, DJ, De Maria, A, Kisslo, J, Weyman, A. The committee on M-mode standardization of the American Society of Echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.Google Scholar
12. de Simone, G, Daniels, SR, Devereux, RB, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 1992; 20: 1251–1260.Google Scholar
13. 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 Scholar
14. Jurcut, R, Giusca, S, La Gerche, A, Vasile, S, Ginghina, C, Voigt, JU. The echocardiographic assessment of the right ventricle: what to do in 2010? Eur J Echocardiogr 2010; 11: 81–96.Google Scholar
15. Mangner, N, Scheuermann, K, Winzer, E, et al. Childhood obesity: impact on cardiac geometry and function. JACC Cardiovasc Imaging 2014; 7: 1198–1205.Google Scholar
16. Porcar-Almela, M, Codoñer-Franch, P, Tuzón, M, Navarro-Solera, M, Carrasco-Luna, J, Ferrando, J. Left ventricular diastolic function and cardiometabolic factors in obese normotensive children. Nutr Metab Cardiovasc Dis 2015; 25: 108–115.Google Scholar
17. Toprak, A, Wang, H, Chen, W, Paul, T, Srinivasan, S, Berenson, G. Relation of childhood risk factors to left ventricular hypertrophy (eccentric or concentric) in relatively young adulthood (from the Bogalusa Heart Study). Am J Cardiol 2008; 101: 1621–1625.Google Scholar
18. Tadic, M, Ivanovic, B, Celic, V, Cuspidi, C. Are the metabolic syndrome, blood pressure pattern, and their interaction responsible for the right ventricular remodeling? Blood Press Monit 2013; 18: 195–202.Google Scholar
19. Li, NY, Yu, J, Zhang, XW, et al. Features of left ventricular hypertrophy in patients with metabolic syndrome with or without comparable blood pressure: a meta-analysis. Endocrine 2013; 43: 548–563.Google Scholar
20. Gidding, SS, Palermo, RA, DeLoach, SS, Keith, SW, Falkner, B. Associations of cardiac structure with obesity, blood pressure, inflammation, and insulin resistance in African-American adolescents. Pediatr Cardiol 2014; 35: 307–314.Google Scholar
21. Karamitsos, TD, Karvounis, HI, Dalamanga, EG, et al. Early diastolic impairment of diabetic heart: the significance of right ventricle. Int J Cardiol 2007; 114: 218–223.Google Scholar
22. Straznicky, NE, Grima, MT, Sari, CI, et al. The relation of glucose metabolism to left ventricular mass and function and sympathetic nervous system activity in obese subjects with metabolic syndrome. J Clin Endocrinol Metab 2013; 98: 227–237.Google Scholar
23. Widya, RL, van der Meer, RW, Smit, JW, et al. Right ventricular involvement in diabetic cardiomyopathy. Diabetes Care 2013; 36: 457–462.Google Scholar
24. Korkmaz, O, Gursu, HA, Karagun, BS. Comparison of echocardiographic findings with laboratory parameters in obese children. Cardiol Young 2015; 14: 1–6.Google Scholar
25. Faganello, G, Cioffi, G, Faggiano, P, et al. Does metabolic syndrome worsen systolic dysfunction in diabetes? The shortwave study. Acta Diabetol 2015; 52: 143–151.Google Scholar
26. Karakurt, O, Oztekin, S, Yazıhan, N, Akdemir, R. Impaired right ventricular functions in metabolic syndrome patients with preserved left ventricular ejection fraction. Turk Kardiyol Dern Ars 2011; 39: 549–556.Google Scholar
27. Tadic, M, Ivanovic, B, Celic, V, Neskovic, A. Do nondipping pattern and metabolic syndrome impact left ventricular geometry and global function in hypertensive patients? Clin Exp Hypertens 2013; 35: 637–644.Google Scholar
28. Akçay, M, Aslan, AN, Kasapkara, HA, et al. Assessment of the left ventricular function in normotensive prediabetics: a tissue Doppler echocardiography study. Arch Endocrinol Metab 2016; 60: 341–347.Google Scholar
29. Gökdeniz, T, Erkol, A, Kalaycıoğlu, E, et al. Relation of epicardial fat thickness to subclinical right ventricular dysfunction assessed by strain and strain rate imaging in subjects with metabolic syndrome: a two-dimensional speckle tracking echocardiography study. Echocardiography 2015; 32: 248–256.Google Scholar
30. Juonala, M, Singh, GR, Davison, B, et al. Childhood metabolic syndrome, inflammation and carotid intima-media thickness. The Aboriginal Birth Cohort Study. Int J Cardiol 2016; 203: 32–36.Google Scholar
31. Elshorbagy, HH, Fouda, ER, Kamal, NM, Bassiouny, MM, Fathi, WM. Evaluation of epicardial fat and carotid intima-media thickness in obese children. Iran J Pediatr 2016; 26: 2968.Google Scholar
32. Hirata, C, Miyai, N, Idoue, A, et al. Effect of metabolic syndrome components and their clustering on carotid atherosclerosis in a sample of the general Japanese population. Hypertens Res 2016; 39: 362–366.Google Scholar
33. Alp, H, Eklioğlu, BS, Atabek, ME, et al. Evaluation of epicardial adipose tissue, carotid intima-media thickness and ventricular functions in obese children and adolescents. J Pediatr Endocrinol Metab 2014; 27: 827–835.Google Scholar
34. Bai, Y, Sun, L, Du, L, et al. Association of circulating levels of asymmetric dimethylarginine (ADMA) with carotid intima-media thickness: evidence from 6168 participants. Ageing Res Rev 2013; 12: 699–707.Google Scholar
35. Palomo, I, Contreras, A, Alarcón, LM, et al. Elevated concentration of asymmetric dimethylarginine (ADMA) in individuals with metabolic syndrome. Nitric Oxide 2011; 24: 224–228.Google Scholar