Atrial myocardial deformation properties in obese nonhypertensive children.
BACKGROUND
Obesity in adulthood is associated with a higher occurrence of atrial arrhythmias. Obese children, without arterial hypertension, may be a unique clinical opportunity to evaluate the effect of obesity, per se, on atrial myocardial function, excluding the influence of possible comorbidities. We sought to define the preclinical effects of obesity on the atrial function of healthy children with excess weight who have no other clinically appreciable cause of heart disease, by using the more sensitive ultrasonic-derived strain (S) and S rate imaging.


METHODS
We studied 320 children divided into two groups: obese children (group O; n = 160; age 12 +/- 3 years); and healthy lean children, comparable for age, sex, and pubertal stage (referents; n = 160; mean age 12 +/- 3 years).


RESULTS
Systolic blood pressure (BP) and diastolic BP, as well as 24-hour systolic BP and 24-hour diastolic BP were comparable between groups. Left ventricular mass/height(2.7) and left atrial dimensions were increased (P < .0001) in group O (46 +/- 12 g/m(2.7)) compared with referents (31 +/- 14 g/m(2.7)). Standard echocardiographic indices of global left ventricular systolic function were similar in the two groups. Obese children showed atrial peak systolic S rate (2.5 +/- 1.2 (s-1)) values lower (P < .0001) than that of referents (4.9 +/- 1.6(s-1)) in both left and right atria. In multivariable analysis, average peak systolic atrial S was significantly correlated with glycemia (P < .05, coefficient -0.23), body mass index (P < .01, coefficient -0.19), and left ventricular mass (P < .05, coefficient -0.17).


CONCLUSIONS
Our study demonstrated that obesity, in absence of hypertension, is associated with reduced atrial myocardial deformation properties already in childhood involving both right and left atria.
Di Salvo
Giovanni
G
Second University of Naples, Naples, Italy. giodisal@yahoo.it
Pacileo
Giuseppe
G
Del Giudice
Emanuele Miraglia
EM
Natale
Francesco
F
Limongelli
Giuseppe
G
Verrengia
Marina
M
Rea
Alessandra
A
Fratta
Fiorella
F
Castaldi
Biagio
B
Gala
Simona
S
Coppola
Filomena
F
Russo
Maria Giovanna
MG
Caso
Pio
P
Perrone
Laura
L
Calabro'
Raffaele
R
D000293:Adolescent; D016279:Atrial Function, Left / Q000502:physiology*; D016280:Atrial Function, Right / Q000502:physiology*; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D002648:Child; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D016016:Proportional Hazards Models; D012016:Reference Values; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity