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Impact of Obesity on Left Ventricular Geometry and Function in Pediatric Patients after Successful Aortic Coarctation Repair
Author(s) -
Di Salvo Giovanni,
Gala Simona,
Castaldi Biagio,
Baldini Luca,
Limongelli Giuseppe,
D’Andrea Antonello,
Scognamiglio Giancarlo,
Sarubbi Berardo,
Caso Pio,
Pacileo Giuseppe,
Giovanna Russo Maria,
Calabrò Raffaele
Publication year - 2011
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2011.01449.x
Subject(s) - medicine , cardiology , obesity , speckle tracking echocardiography , blood pressure , diastole , ambulatory blood pressure , heart failure , ejection fraction
Aims: To evaluate if obesity has an additional negative impact on left ventricular (LV) geometry and function in normotensive pediatric patients >12 months after successful treatment of aortic coarctation (CoA). Methods and Results: We studied 40 CoA patients (mean age 14 ± 3 years, and male sex 70%), of them 10 were obese and 30 lean. Both groups were age and sex comparable. The entire studied sample underwent 24‐ambulatory blood pressure (BP) monitoring, standard echocardiographic evaluation, and speckle tracking study. Both office and 24‐hour diastolic BP were significantly increased in obese patients. Obese CoA patients showed increased LV mass (52 ± 13 g/m 2.7 vs. 43 ± 9 g/m 2.7 , P = 0.02), and significant reduction in E/A compared with lean CoA patients. Myocardial deformation properties were significantly reduced in obese CoA patients in all the three studied planes (longitudinal, radial, and circumferential) compared with CoA lean patients. LV twist values showed a significant reduction in the obese CoA group (9.9°± 2.2° vs. 14.5°± 2.3°, P < 0.0001). Conclusions: Our study shows that obesity in successfully treated CoA children, has an additional negative effect on BP, LV mass, and cardiac function. These findings are of particular concern, since life expectancy in CoA patients is limited mainly by atherosclerosis, and all the obesity‐associated abnormalities found are harbingers of higher cardiovascular risk. (Echocardiography 2011;28:907‐912)