Cardiology Department, Hospital Clínico San Carlos, Madrid, Spain.
Obesity (Silver Spring). 2011 Nov;19(11):2268-73. doi: 10.1038/oby.2011.157. Epub 2011 Jun 30.
Obesity is considered as a strong risk factor for cardiovascular morbidity and mortality. 3D-wall motion tracking echocardiography (3D-WMT) provides information regarding different parameters of left ventricular (LV) myocardial deformation. Our aim was to assess the presence of early myocardial deformation abnormalities in nonselected obese children free from other cardiovascular risk factors. Thirty consecutive nonselected obese children and 42 healthy volunteer children were enrolled. None of them had any cardiovascular risk factor. Every subject underwent a 2D-echo examination and a 3D-WMT study. Mean age was 13.9 ± 2.56 and 13.25 ± 2.68 years in the nonobese and obese groups, respectively (59.7% and 40.3% male). Statistically significant differences were found for: interventricular septum thickness, LV posterior wall thickness, LV end-diastolic volume, LV end-systolic volume, left atrium volume, LV mass, and lateral annulus peak velocity. Regarding the results obtained by 3D-WMT assessment, all the evaluated parameters were statistically significantly different between the two groups. When the influence of obesity on the different echocardiographic variables was evaluated by means of multivariate logistic regression analysis, the strongest relationship with obesity was found for LV average circumferential strain (β-coefficient: 0.74; r(2): 0.55; P: 0.003). Thus, obesity cardiomyopathy is associated not only with structural cardiac changes, but also with myocardial deformation changes. Furthermore, this association occurs as early as in the childhood and it is independent from any other cardiovascular risk factor. The most related parameter to obesity is LV circumferential strain.
肥胖被认为是心血管发病率和死亡率的一个重要危险因素。3D 壁运动跟踪超声心动图（3D-WMT）提供了关于左心室（LV）心肌变形的不同参数的信息。我们的目的是评估无其他心血管危险因素的非选择性肥胖儿童是否存在早期心肌变形异常。连续纳入 30 名非选择性肥胖儿童和 42 名健康志愿者儿童。他们均无任何心血管危险因素。所有受试者均接受 2D 超声心动图检查和 3D-WMT 研究。非肥胖组和肥胖组的平均年龄分别为 13.9 ± 2.56 岁和 13.25 ± 2.68 岁（59.7%和 40.3%为男性）。结果发现：室间隔厚度、LV 后壁厚度、LV 舒张末期容积、LV 收缩末期容积、左心房容积、LV 质量和外侧瓣环峰值速度存在统计学显著差异。关于 3D-WMT 评估结果，两组间所有评估参数均存在统计学显著差异。当通过多元逻辑回归分析评估肥胖对不同超声心动图变量的影响时，LV 平均环向应变与肥胖的关系最强（β 系数：0.74；r²：0.55；P：0.003）。因此，肥胖性心肌病不仅与心脏结构变化有关，还与心肌变形变化有关。此外，这种关联早在儿童时期就存在，并且独立于任何其他心血管危险因素。与肥胖相关性最强的参数是 LV 环向应变。
