title: Impact of obesity on left ventricular geometry and function in pediatric patients after successful aortic coarctation repair.
abstract: OBJECTIVE
  To evaluate if obesity has an additional negative impact on left ventricular (LV) geometry and function in normotensive pediatric patients >12 months after successful treatment of aortic coarctation (CoA).
  
  
  RESULTS
  We studied 40 CoA patients (mean age 14 ± 3 years, and male sex 70%), of them 10 were obese and 30 lean. Both groups were age and sex comparable. The entire studied sample underwent 24-ambulatory blood pressure (BP) monitoring, standard echocardiographic evaluation, and speckle tracking study. Both office and 24-hour diastolic BP were significantly increased in obese patients. Obese CoA patients showed increased LV mass (52 ± 13 g/m(2.7) vs. 43 ± 9 g/m(2.7) , P = 0.02), and significant reduction in E/A compared with lean CoA patients. Myocardial deformation properties were significantly reduced in obese CoA patients in all the three studied planes (longitudinal, radial, and circumferential) compared with CoA lean patients. LV twist values showed a significant reduction in the obese CoA group (9.9° ± 2.2° vs. 14.5° ± 2.3°, P < 0.0001).
  
  
  CONCLUSIONS
  Our study shows that obesity in successfully treated CoA children, has an additional negative effect on BP, LV mass, and cardiac function. These findings are of particular concern, since life expectancy in CoA patients is limited mainly by atherosclerosis, and all the obesity-associated abnormalities found are harbingers of higher cardiovascular risk.
authors.affiliation: Department of Pediatric Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy. giodisal@yahoo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Salvo
authors.forename: Simona
authors.initials: S
authors.lastname: Gala
authors.forename: Biagio
authors.initials: B
authors.lastname: Castaldi
authors.forename: Luca
authors.initials: L
authors.lastname: Baldini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Limongelli
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Scognamiglio
authors.forename: Berardo
authors.initials: B
authors.lastname: Sarubbi
authors.forename: Pio
authors.initials: P
authors.lastname: Caso
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pacileo
authors.forename: Maria
authors.initials: M
authors.lastname: Giovanna Russo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D000293:Adolescent; D001017:Aortic Coarctation / Q000150:complications / Q000601:surgery*; D001794:Blood Pressure; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology*