Kosuyolu Heart J 2013;16(3)
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Kosuyolu Heart J 2013;16(3):220-228 - doi: 10.5578/kkd.6093
Effect of Obesity on Left Ventricular Diastolic Function in Children

Effect of Obesity on Left Ventricular Diastolic Function in Children

Şeref Alpsoy1, Aydın Akyüz1, Dursun Çayan Akkoyun1, Burçin Nalbantoğlu2, Birol Topçu3,
Hasan Değirmenci1, Mustafa Metin Donma2


1 Department of Cardiology, Tekirdag Namik Kemal University Research and Practice Hospital, Tekirdag, Turkey

2 Department of Pediatrics, Tekirdag Namik Kemal University Research and Practice Hospital, Tekirdag, Turkey

3 Department of Statistics, Tekirdag Namik Kemal University Research and Practice Hospital, Tekirdag, Turkey

ABSTRACT

Introduction: We aimed to asses two dimensional, M-Mode, conventional and tissue Doppler echocardiographic parameters of left ventricle and to evaluate the effects of antropometric and biochemical factors on these parameters in obese and normal weight children.

Patients and Methods: This observational cross-sectional study included 60 obese and 60 non-obese children aged 8-15 years. Echocardiographic parameters of left ventricle were measured in all subjects and investigated the relationship with anthropometric and biochemical factors.

Results: Waist circumference, body mass index-Z (BMI-Z) score, systolic and diastolic blood pressure, triglyceride, fasting glucose, insulin concentrations, and homeostatic model assessment (HOMA) index were significantly higher, whereas high density lipoprotein-cholesterol (HDL-C) concentration was significantly lower in the obese than in the non-obese group. Mitral annulus septal E' and E'/A', mitral annulus lateral E' and E'/A', anterior E' and E'/A', inferior E' and E'/A' values were significantly lower, whereas mitral E/septal E' and mitral E/lateral E' values were significantly higher in obese than in non-obese subjects. Most of the tissue Doppler parameters were correlated with waist circumference, BMI-Z score, fasting blood glucose, HOMA, systolic and diastolic blood pressure, serum insulin levels, triglyceride and HDL. Waist circumference and BMI-Z score were decisive for some tissue Doppler parameters.

Conclusion: Left ventricular diastolic functions are impaired in obese children compared to that of their peers. Although there were correlation between diastolic dysfunction parameters and risk factors, obesity itself is related with reduction of left ventricular diastolic functions.

Key Words: Child, pulsed Doppler echocardiography, left ventricle, obesity.

Received: 29.07.2013 Accepted: 06.08.2013

Correspondence

Dr. Şeref Alpsoy

Tekirdağ Namık Kemal Üniversitesi Araştırma ve

Uygulama Hastanesi, Kardiyoloji Kliniği,

Tekirdağ-Türkiye

e-posta: serefalpsoy@gmail.com

Effect of Obesity on Left Ventricular Diastolic Function in Children

Çocuklarda Obezitenin Sol Ventrikül Diyastolik Fonksiyonları Üzerine Etkisi

Effect of Obesity on Left Ventricular Diastolic Function in Children

Şeref Alpsoy1, Aydın Akyüz1, Dursun Çayan Akkoyun1, Burçin Nalbantoğlu2, Birol Topçu3,
Hasan Değirmenci1, Mustafa Metin Donma2


1 Tekirdağ Namık Kemal Üniversitesi Araştırma ve Uygulama Hastanesi, Kardiyoloji Kliniği, Tekirdağ, Türkiye

1 Department of Cardiology, Tekirdag Namik Kemal University Research and Practice Hospital,

Tekirdag, Turkey

2 Tekirdağ Namık Kemal Üniversitesi Araştırma ve Uygulama Hastanesi, Çocuk Hastalıkları Kliniği,

Tekirdağ, Türkiye

2 Department of Pediatrics, Tekirdag Namik Kemal University Research and Practice Hospital, Tekirdag, Turkey

3 Tekirdağ Namık Kemal Üniversitesi Araştırma ve Uygulama Hastanesi, İstatistik Anabilim Dalı,

Tekirdağ, Türkiye

3 Department of Statistics, Tekirdag Namik Kemal University Research and Practice Hospital, Tekirdag, Turkey

ÖZET

Amaç: Bu çalışmada obez ve normal kilolu çocuklarda iki boyutlu, M-Mod, geleneksel ve doku Doppler ekokardiyografiyle sol ventrikül diyastolik fonksiyon parametrelerini ölçmeyi ve bu parametreler üzerine antropometrik ve biyokimyasal faktörlerin etkilerini değerlendirmeyi amaçladık.

Hastalar ve Yöntem: Bu olgu-kontrollü kesitsel çalışmaya, 8-15 yaş arası 60 obez ve 60 normal kilolu çocuk dahil edildi. Çocukların antropometrik ve biyokimyasal değerleriyle sol ventrikül ekokardiyografik parametreleri ölçüldü ve aralarındaki ilişki araştırıldı.

Bulgular: Obez grupta bel çevresi ve beden kitle indeksi (BKİ-Z) skoru, sistolik ve diyastolik kan basıncı, trigliserid, açlık kan şekeri, insülin ve homeostatik modeli değerlendirmesi (HOMD) indeksi anlamlı olarak yüksekken yüksek yoğunluklu lipoprotein kolesterol (YYL-K) konsantrasyonu anlamlı derecede düşük bulundu. Mitral annulus septal E' ve E'/A', mitral annulus lateral E' ve E'/A', anteriyor E' ve E'/A', inferiyor E' ve E'/A' değerleri anlamlı derecede düşük bulundu, mitral E'/septal E' ve mitral E/lateral E değerleri anlamlı olarak daha yüksekti. Çoğu doku Doppler parametreleri ile bel çevresi, BKİ-Z skoru, açlık kan şekeri, HOMD, serum insülin düzeyi sistolik ve diyastolik kan basıncı, trigliserid ve YYL-K arasında korelasyon vardı. Bel çevresi ve BKİ-Z skoru bazı doku Doppler parametreleri için belirleyiciydi.

Sonuç: Obez çocuklarda akranlarına göre sol ventrikül diyastolik fonksiyonları bozulmuştur. Risk faktörleriyle diyastolik fonksiyon parametreleri arasında korelasyon olsa da, obezitenin kendisi sol ventrikül diyastolik fonksiyonlarında azalmayla ilişkilidir.

Anahtar Kelimeler: Çocuk, atımlı Doppler ekokardiyografi, sol ventrikül, obezite.

Geliş Tarihi: 29.07.2013 Kabul Tarihi: 06.08.2013

ABSTRACT

Introduction: We aimed to asses two dimensional, M-Mode, conventional and tissue Doppler echocardiographic parameters of left ventricle and to evaluate the effects of antropometric and biochemical factors on these parameters in obese and normal weight children.

Patients and Methods: This observational cross-sectional study included 60 obese and 60 non-obese children aged 8-15 years. Echocardiographic parameters of left ventricle were measured in all subjects and investigated the relationship with anthropometric and biochemical factors.

Results: Waist circumference, body mass index-Z (BMI-Z) score, systolic and diastolic blood pressure, triglyceride, fasting glucose, insulin concentrations, and homeostatic model assessment (HOMA) index were significantly higher, whereas high density lipoprotein-cholesterol (HDL-C) concentration was significantly lower in the obese than in the non-obese group. Mitral annulus septal E' and E'/A', mitral annulus lateral E' and E'/A', anterior E' and E'/A', inferior E' and E'/A' values were significantly lower, whereas mitral E/septal E' and mitral E/lateral E' values were significantly higher in obese than in non-obese subjects. Most of the tissue Doppler parameters were correlated with waist circumference, BMI-Z score, fasting blood glucose, HOMA, systolic and diastolic blood pressure, serum insulin levels, triglyceride and HDL. Waist circumference and BMI-Z score were decisive for some tissue Doppler parameters.

Conclusion: Left ventricular diastolic functions are impaired in obese children compared to that of their peers. Although there were correlation between diastolic dysfunction parameters and risk factors, obesity itself is related with reduction of left ventricular diastolic functions.

Key Words: Child, pulsed Doppler echocardiography, left ventricle, obesity.

Received: 29.07.2013 Accepted: 06.08.2013

Yazışma Adresi/Correspondence

Dr. Şeref Alpsoy

Tekirdağ Namık Kemal Üniversitesi Araştırma ve

Uygulama Hastanesi, Kardiyoloji Kliniği,

Tekirdağ-Türkiye

e-posta: serefalpsoy@gmail.com

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