Yıldırım Yıldız Nihan, Uçar Tayfun, Ramoğlu Mehmet G, Berberoğlu Merih, Şıklar Zeynep, Tutar Ercan, Atalay Semra
Ankara University, School of Medicine, Department of Pediatrics, Ankara, Turkey.
Ankara University, School of Medicine, Department of Pediatric Cardiology, Ankara, Turkey.
Cardiol Young. 2021 Apr;31(4):568-576. doi: 10.1017/S1047951120004369. Epub 2020 Dec 14.
Ventricular repolarisation changes may lead to sudden cardiac death in obese individuals. We aimed to investigate the relationship between ventricular repolarisation changes, echocardiographic parameters, anthropometric measures, and metabolic syndrome laboratory parameters in obese children.
The study involved 81 obese and 82 normal-weight healthy children with a mean age of 12.3 ± 2.7 years. Anthropometric measurements of participants were evaluated according to nomograms. Obese patients were subdivided into two groups; metabolic syndrome and non-metabolic syndrome obese. Fasting plasma glucose, fasting insulin, and lipid profile were measured. QT/QTc interval, QT/QTc dispersions were measured, and left ventricular systolic and diastolic measurements were performed.
Body weight, body mass index, relative body mass index, waist/hip circumference ratio, and systolic and diastolic blood pressures were significantly higher in obese children. QT and QTc dispersions were significantly higher in obese children and also obese children with metabolic syndrome had significantly higher QT and QTc dispersions compared to non-metabolic syndrome obese children (p < 0.001) and normal-weight healthy children (p < 0.001). Waist/hip circumference ratio, body mass index, and relative body mass index were the most important determinant of QT and QTc dispersions. Left ventricular wall thickness (left ventricular posterior wall thickness at end-diastole, left ventricular posterior wall thickness at end-systole, interventricular septal thickness at end-diastole) and left ventricular mass index were significantly higher and ejection fraction was lower in obese children. Left ventricular mass index and interventricular septal thickness at end-diastole were positively correlated with QT and QTc dispersions.
Our study demonstrated that QT/ QTc interval prolongation and increase in QT and QTc dispersion on electrocardiogram may be found at an early age in obese children.
心室复极改变可能导致肥胖个体心源性猝死。我们旨在研究肥胖儿童心室复极改变、超声心动图参数、人体测量指标和代谢综合征实验室参数之间的关系。
该研究纳入了81名肥胖儿童和82名平均年龄为12.3±2.7岁的正常体重健康儿童。根据列线图评估参与者的人体测量指标。肥胖患者被分为两组：代谢综合征肥胖组和非代谢综合征肥胖组。测量空腹血糖、空腹胰岛素和血脂谱。测量QT/QTc间期、QT/QTc离散度，并进行左心室收缩和舒张测量。
肥胖儿童的体重、体重指数、相对体重指数、腰臀围比以及收缩压和舒张压显著更高。肥胖儿童的QT和QTc离散度显著更高，并且与非代谢综合征肥胖儿童（p<0.001）和正常体重健康儿童（p<0.001）相比，代谢综合征肥胖儿童的QT和QTc离散度也显著更高。腰臀围比、体重指数和相对体重指数是QT和QTc离散度的最重要决定因素。肥胖儿童的左心室壁厚度（舒张末期左心室后壁厚度、收缩末期左心室后壁厚度、舒张末期室间隔厚度）和左心室质量指数显著更高，射血分数更低。左心室质量指数和舒张末期室间隔厚度与QT和QTc离散度呈正相关。
我们的研究表明，肥胖儿童在早期可能出现心电图上QT/QTc间期延长以及QT和QTc离散度增加。
