Dias Katrin A, Spence Angela L, Sarma Satyam, Oxborough David, Timilsina Anita S, Davies Peter S W, Cain Peter A, Leong Gary M, Ingul Charlotte B, Coombes Jeff S
School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, Australia.
School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.
Int J Cardiol. 2017 Aug 1;240:313-319. doi: 10.1016/j.ijcard.2017.03.047. Epub 2017 Mar 11.
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.
LV morphology was assessed using magnetic resonance imaging (MRI) in 20 adolescents (11 normal-weight [BMI equivalent to 18kg/m-25kg/m] and 9 obese [BMI equivalent to ≥30kg/m]); 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.
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), and lower SR in early diastole (-0.61s), 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).
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.
NCT01991106.
儿童肥胖会使个体易患心血管疾病，并增加过早全因死亡率的风险。本研究的目的是确定肥胖和正常体重青少年左心室形态和功能的差异。此外，还探讨了左心室结果、心肺适能（CRF）和肥胖之间的关系。
对20名青少年（11名正常体重[BMI相当于18kg/m² - 25kg/m²]和9名肥胖者[BMI相当于≥30kg/m²]；年龄13.3±1.1岁，45%为女性， Tanner青春期3期[2 - 4期]）使用磁共振成像（MRI）评估左心室形态。使用整体纵向应变（GLS）、应变率（SR）和传统超声心动图指标评估左心室功能。还评估了CRF（峰值耗氧量）、体脂百分比（双能X线吸收法）、腹部脂肪组织（MRI）和血液生化标志物。
与正常体重青少年相比，肥胖青少年的左心室功能明显较差（P<0.05），表现为GLS更高（+6.29%）、收缩期SR更高（+0.17s）、舒张早期SR更低（-0.61s）以及组织多普勒速度更低（S' -2.7cm/s；e' -2.3cm/s；A' -1.1cm/s）。以去脂体重为指标时，左心室形态在两组间无差异（P>0.05）。心肌收缩性和舒张性、肥胖、动脉血压和心肺适能之间存在中度至强关联（r = 0.49 - 0.71，P<0.05）。
青少年肥胖与左心室收缩和舒张功能改变有关。左心室功能、CRF和肥胖之间的显著关系凸显了多学科生活方式干预对治疗该人群左心室功能减退的潜在效用。
NCT01991106。
