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通过组织多普勒成像研究评估无高血压肥胖儿童的左心室功能。

Evaluation of left ventricular function in obese children without hypertension by a tissue Doppler imaging study.

作者信息

Ghandi Yazdan, Sharifi Mehrzad, Habibi Danial, Dorreh Fatemeh, Hashemi Mojtaba

机构信息

Department of Pediatric Cardiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.

Department of Cardiac Surgery, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.

出版信息

Ann Pediatr Cardiol. 2018 Jan-Apr;11(1):28-33. doi: 10.4103/apc.APC_75_17.

Abstract

BACKGROUND

The prevalence of obesity is increasing worldwide. Obese children without hypertension are becoming an important health challenge.

AIMS

Complications of obesity in adults are well established, but in obese children, cardiac dysfunction has not been reported clinically.

SETTINGS AND DESIGN

The present crosssectional study investigates subclinical systolic and diastolic dysfunction using echocardiographic modalities.

MATERIALS AND METHODS

Twentyfive youngsters with body mass index (BMI) >30 and 25 healthy children with BMI <25 were assigned into case and control group, respectively. In all participants, complete cardiovascular examination, electrocardiography, and echocardiography were fulfilled. Echocardiography surveys included standard, pulsed wave Doppler (PWD), and tissue Doppler imaging (TDI).

STATISTICAL ANALYSIS USED

SPSS software, version 24.

RESULTS

The two groups were matched for age and sex. The resting heart rate and blood pressure were markedly higher in the obese group ( = 0.0001) though they were within the normal range in either category. Ejection fraction in the two groups was similar. Left ventricular (LV) mass ( = 0.0001), LV mass index ( = 0.029), left atrialtoaortic diameter ratio ( = 0.0001), and LV enddiastolic diameter ( = 0.008) were significantly greater in the case group, indicating cardiomegaly and subclinical systolic and diastolic dysfunction. Except for the aortic velocity, all PWD variables were considerably lower in the case group, suggesting subclinical diastolic dysfunction. All TDI parameters varied significantly between the two categories. There was a direct correlation between isovolumetric relaxation time and BMI.

CONCLUSIONS

Obesity in children without hypertension is associated with subclinical systolic and diastolic cardiac dysfunction. We propose the evaluation of blood pressure as well as myocardial performance using PWD and TDI in all obese children without hypertension, regularly.

摘要

背景

全球肥胖患病率正在上升。无高血压的肥胖儿童正成为一项重大的健康挑战。

目的

肥胖在成人中的并发症已得到充分证实,但在肥胖儿童中,临床尚未报道心脏功能障碍。

设置与设计

本横断面研究使用超声心动图方法调查亚临床收缩和舒张功能障碍。

材料与方法

将25名体重指数(BMI)>30的青少年和25名BMI<25的健康儿童分别分为病例组和对照组。对所有参与者进行了完整的心血管检查、心电图和超声心动图检查。超声心动图检查包括标准、脉冲波多普勒(PWD)和组织多普勒成像(TDI)。

所用统计分析方法

SPSS软件24版。

结果

两组在年龄和性别上相匹配。肥胖组静息心率和血压明显更高(P = 0.0001),尽管两组的这些指标均在正常范围内。两组的射血分数相似。病例组的左心室(LV)质量(P = 0.0001)、LV质量指数(P = 0.029)、左心房与主动脉直径比(P = 0.0001)和LV舒张末期直径(P = 0.008)显著更大,表明存在心脏肥大以及亚临床收缩和舒张功能障碍。除主动脉速度外,病例组所有PWD变量均显著更低,提示亚临床舒张功能障碍。两类之间所有TDI参数差异均有统计学意义。等容舒张时间与BMI之间存在直接相关性。

结论

无高血压的儿童肥胖与亚临床收缩和舒张性心脏功能障碍相关。我们建议对所有无高血压的肥胖儿童定期使用PWD和TDI评估血压以及心肌功能。

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