Alp Hayrullah, Karaarslan Sevim, Eklioğlu Beray S, Atabek Mehmet E, Baysal Tamer
aDepartment of Pediatric Cardiology, Malatya State Hospital, Malatya bDepartment of Pediatric Cardiology, Necmettin Erbakan University, Meram School of Medicine Hospital cDepartment of Pediatric Endocrinology, Necmettin Erbakan University, Meram School of Medicine Hospital, Konya, Turkey.
J Hypertens. 2014 Jun;32(6):1283-92. doi: 10.1097/HJH.0000000000000176.
Obesity and hypertension are associated with structural and functional cardiac change in children and adults. The aim of the study is to evaluate the effect of hypertension and obesity on left ventricular geometric patterns and cardiac functions assessed by conventional and Doppler echocardiography.
Four hundred and thirty obese children, aged 6-17 years and 150 age and sex-matched healthy controls, were included in the study. Left ventricular geometry was classified as concentric hypertrophy, eccentric hypertrophy, concentric remodeling and normal geometry.
Concentric hypertrophy group had the worst subclinical systolic and diastolic cardiac functions among all left ventricular geometric patterns. BMI and total adipose tissue mass are the predictors of abnormal ventricular geometry. Apart from the increase in carotid intima-media and epicardial adipose tissue thicknesses in different left ventricular geometry patterns, they are not predictable for abnormal geometry.
The variety of alterations in cardiac function and morphology that has been observed in obese adults, appears to start earlier in life. Obesity and hypertension were clearly associated with the left ventricular geometry. Also, subclinical systolic and load-depended diastolic dysfunctions can be detected in obese hypertensive children with concentric hypertrophy.
肥胖和高血压与儿童及成人的心脏结构和功能变化相关。本研究的目的是评估高血压和肥胖对通过传统及多普勒超声心动图评估的左心室几何形态和心脏功能的影响。
本研究纳入了430名6至17岁的肥胖儿童以及150名年龄和性别匹配的健康对照。左心室几何形态被分类为向心性肥厚、离心性肥厚、向心性重构和正常几何形态。
在所有左心室几何形态中，向心性肥厚组的亚临床收缩和舒张心脏功能最差。体重指数（BMI）和总脂肪组织量是心室几何形态异常的预测指标。除了不同左心室几何形态模式下颈动脉内膜中层厚度和心外膜脂肪组织厚度增加外，它们无法预测几何形态异常。
在肥胖成年人中观察到的各种心脏功能和形态改变，似乎在生命早期就已开始。肥胖和高血压与左心室几何形态明显相关。此外，在患有向心性肥厚的肥胖高血压儿童中可检测到亚临床收缩和负荷依赖性舒张功能障碍。
