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Int J Cardiol. 2017 Mar 11. pii: S0167-5273(17)30385-6. doi: 10.1016/j.ijcard.2017.03.047. [Epub ahead of print]

Left ventricular morphology and function in adolescents: Relations to fitness and fatness.

Author information

1
School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, Australia.
2
School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.
3
Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA; Department of Internal Medicine, University of Texas Southwestern Medical Centre, Dallas, TX, USA.
4
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK.
5
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
6
Children's Nutrition Research Centre, The University of Queensland, Brisbane, QLD, Australia.
7
Heart Care Partners, The Wesley Hospital, Brisbane, QLD, Australia.
8
Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia; Department of Paediatric Endocrinology, Lady Cilento Children's Hospital, Brisbane, QLD, Australia.
9
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Helse Midt-Norge RHF, Strandvegen 1, Stjordal, Norway.
10
School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, Australia. Electronic address: jcoombes@uq.edu.au.

Abstract

BACKGROUND:

Obesity in childhood predisposes individuals to cardiovascular disease and increased risk of premature all-cause mortality. The aim of this study was to determine differences in LV morphology and function in obese and normal-weight adolescents. Furthermore, relationships between LV outcomes, cardiorespiratory fitness (CRF) and adiposity were explored.

METHODS:

LV morphology was assessed using magnetic resonance imaging (MRI) in 20 adolescents (11 normal-weight [BMI equivalent to 18kg/m2-25kg/m2] and 9 obese [BMI equivalent to ≥30kg/m2]); 13.3±1.1years, 45% female, Tanner puberty stage 3 [2-4]) using magnetic resonance imaging (MRI). Global longitudinal strain (GLS), strain rate (SR) and traditional echocardiographic indices were used to assess LV function. CRF (peak oxygen consumption), percent body fat (dual-energy x-ray absorptiometry), abdominal adipose tissue (MRI), and blood biochemistry markers were also evaluated.

RESULTS:

Adolescents with obesity showed significantly poorer LV function compared to normal-weight adolescents (P<0.05) indicated by higher GLS (+6.29%) and SR in systole (+0.17s-1), and lower SR in early diastole (-0.61s-1), and tissue Doppler velocities (S' -2.7cm/s; e' -2.3cm/s; A' -1.1cm/s). There were no group differences in LV morphology when indexed to fat free mass (P>0.05). Moderate to strong associations between myocardial contractility and relaxation, adiposity, arterial blood pressure and cardiorespiratory fitness were noted (r=0.49-0.71, P<0.05).

CONCLUSION:

Obesity in adolescence is associated with altered LV systolic and diastolic function. The notable relationship between LV function, CRF and adiposity highlights the potential utility of multidisciplinary lifestyle interventions to treat diminished LV function in this population.

CLINICAL TRIAL REGISTRATION:

NCT01991106.

KEYWORDS:

Adiposity; Cardiorespiratory fitness; Global longitudinal strain; Global longitudinal strain rate; Left ventricular mass; Tissue Doppler velocities

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