Aslan Eyup, Sert Ahmet, Buyukinan Muammer, Pirgon Mustafa Ozgur, Kurku Huseyin, Yilmaz Hakan, Odabas Dursun
1Department of Pediatric Cardiology,Denizli State Hospital,Denizli,Turkey.
2Department of Pediatric Cardiology,Faculty of Medicine,Selcuk University,Konya,Turkey.
Cardiol Young. 2019 Mar;29(3):310-318. doi: 10.1017/S1047951118002329. Epub 2019 Jan 28.
PurposeThe aim of our study was to assess left ventricle and right ventricle systolic and diastolic functions in obese adolescents with metabolic syndrome using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotis intima-media thickness, and asymmetric dimethyl arginine levels.
A total of 198 obese adolescents were enrolled in the study. The obese patients were divided into metabolic syndrome group and non-metabolic syndrome group. All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulsed, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness.
Obese adolescents were characterised by enlarged left end-diastolic, end-systolic and left atrial diameters, thicker left and right ventricular walls compared with non-obese adolescents. The metabolic syndrome group had normal left ventricle systolic function, impaired diastolic function, and altered global systolic and diastolic myocardial performance. In the metabolic syndrome obese group patients, left ventricle mass was found positively correlated with body mass index, waist and hip circumferences, diastolic blood pressure, age, and waist-to-hip circumference ratio. The carotid intima-media thickness was found positively correlated with waist and hip circumferences and total cholesterol levels. Asymmetric dimethyl arginine levels were found positively correlated with systolic blood pressure, waist-to-hip circumference ratio, and diastolic blood pressure.
The results of this study demonstrate that metabolic syndrome in adolescence is associated with significant changes in myocardial geometry and function. In addition, it has been associated with a high level of asymmetric dimethyl arginine concentration and thicker carotid intima-media thickness reflecting endothelial dysfunction.
目的
我们研究的目的是使用传统超声心动图和脉冲波组织多普勒成像评估患有代谢综合征的肥胖青少年的左心室和右心室的收缩和舒张功能，并研究颈动脉内膜中层厚度和不对称二甲基精氨酸水平。
共有198名肥胖青少年参与了这项研究。肥胖患者被分为代谢综合征组和非代谢综合征组。所有受试者均接受实验室血液检查，包括不对称二甲基精氨酸、完整的二维、脉冲和组织多普勒超声心动图检查，以及颈动脉内膜中层厚度的测量。
与非肥胖青少年相比，肥胖青少年的特征是左室舒张末期、收缩末期和左心房直径增大，左、右心室壁增厚。代谢综合征组左心室收缩功能正常，舒张功能受损，整体收缩和舒张心肌性能改变。在代谢综合征肥胖组患者中，发现左心室质量与体重指数、腰围和臀围、舒张压、年龄以及腰臀比呈正相关。发现颈动脉内膜中层厚度与腰围、臀围和总胆固醇水平呈正相关。不对称二甲基精氨酸水平与收缩压、腰臀比和舒张压呈正相关。
本研究结果表明，青少年代谢综合征与心肌几何形状和功能的显著变化有关。此外，它还与反映内皮功能障碍的高浓度不对称二甲基精氨酸和较厚的颈动脉内膜中层厚度有关。
