Di Salvo Giovanni, Pacileo Giuseppe, Del Giudice Emanuele Miraglia, Natale Francesco, Limongelli Giuseppe, Verrengia Marina, Rea Alessandra, Fratta Fiorella, Castaldi Biagio, Gala Simona, Coppola Filomena, Russo Maria Giovanna, Caso Pio, Perrone Laura, Calabro' Raffaele
Second University of Naples, Naples, Italy.
J Am Soc Echocardiogr. 2008 Feb;21(2):151-6. doi: 10.1016/j.echo.2007.05.028. Epub 2007 Jul 12.
Obesity in adulthood is associated with a higher occurrence of atrial arrhythmias. Obese children, without arterial hypertension, may be a unique clinical opportunity to evaluate the effect of obesity, per se, on atrial myocardial function, excluding the influence of possible comorbidities. We sought to define the preclinical effects of obesity on the atrial function of healthy children with excess weight who have no other clinically appreciable cause of heart disease, by using the more sensitive ultrasonic-derived strain (S) and S rate imaging.
We studied 320 children divided into two groups: obese children (group O; n = 160; age 12 +/- 3 years); and healthy lean children, comparable for age, sex, and pubertal stage (referents; n = 160; mean age 12 +/- 3 years).
Systolic blood pressure (BP) and diastolic BP, as well as 24-hour systolic BP and 24-hour diastolic BP were comparable between groups. Left ventricular mass/height(2.7) and left atrial dimensions were increased (P < .0001) in group O (46 +/- 12 g/m(2.7)) compared with referents (31 +/- 14 g/m(2.7)). Standard echocardiographic indices of global left ventricular systolic function were similar in the two groups. Obese children showed atrial peak systolic S rate (2.5 +/- 1.2 (s-1)) values lower (P < .0001) than that of referents (4.9 +/- 1.6(s-1)) in both left and right atria. In multivariable analysis, average peak systolic atrial S was significantly correlated with glycemia (P < .05, coefficient -0.23), body mass index (P < .01, coefficient -0.19), and left ventricular mass (P < .05, coefficient -0.17).
Our study demonstrated that obesity, in absence of hypertension, is associated with reduced atrial myocardial deformation properties already in childhood involving both right and left atria.
成年期肥胖与房性心律失常的发生率较高相关。无动脉高血压的肥胖儿童可能是一个独特的临床机会，可用于评估肥胖本身对心房心肌功能的影响，排除可能合并症的影响。我们试图通过使用更敏感的超声衍生应变（S）和应变率成像，来确定肥胖对无其他临床明显心脏病病因的超重健康儿童心房功能的临床前影响。
我们研究了320名儿童，分为两组：肥胖儿童（O组；n = 160；年龄12±3岁）；以及年龄、性别和青春期阶段相匹配的健康瘦儿童（对照组；n = 160；平均年龄12±3岁）。
两组之间的收缩压（BP）和舒张压，以及24小时收缩压和24小时舒张压相当。与对照组（31±14 g/m(2.7)）相比，O组（46±12 g/m(2.7)）的左心室质量/身高(2.7)和左心房尺寸增加（P <.0001）。两组的整体左心室收缩功能的标准超声心动图指标相似。肥胖儿童左、右心房的心房收缩期峰值应变率（2.5±1.2（s-1））值低于对照组（4.9±1.6(s-1)）（P <.0001）。在多变量分析中，平均收缩期峰值心房应变与血糖（P <.05，系数 -0.23）、体重指数（P <.01，系数 -0.19）和左心室质量（P <.05，系数 -0.17）显著相关。
我们的研究表明，在无高血压的情况下，肥胖在儿童期就已与涉及左、右心房的心房心肌变形特性降低相关。
