title: Alterations of left ventricular myocardial strain in obese children.
abstract: OBJECTIVE
  Obesity may have implications in the myocardial structural change, which may contribute to mechanical consequences. Using 2D speckle echocardiography, we looked for myocardial changes and investigated their relation to obesity, inflammation, insulin resistance and physical capacity in children with isolated obesity.
  
  
  RESULTS
  Standard echocardiography and 2D strain were prospectively performed in obese children and compared them with age- and sex-matched controls. Z-score body mass index (BMI Z-score), ultra-sensitive C reactive protein, indices of insulin resistance (HOMA-IR) and metabolic stress test were assessed in obese children. Thirty-two consecutive obese patients [age: 12.8 (8-17) years; 15 males; BMI Z-score: 5.8 [2.05-8.6)] were compared with 32 controls. Longitudinal strain and circumferential strain were significantly lower in the obese group (respectively -18.0 ± 2.4% vs. -20.6 ± 2.5%; P = 0.0001 and -18.2 ± 3.5% vs. -20.1 ± 2.3%; P = 0.013), while radial strain did not differ. Longitudinal strain was correlated with HOMA-IR (Pearson's rho = -0.39) and with the exercise capacity (Pearson's rho = 0.62). In the multivariate analysis, after adjusting for age, the mean arterial pressure and left ventricular (LV) mass, the BMI Z-score remained independently related to the longitudinal and circumferential strain.
  
  
  CONCLUSIONS
  Childhood obesity may be associated with an early alteration of the longitudinal and circumferential LV strain. These findings have potentially significant clinical implications for the outcomes and follow-up of obese children meriting further studies.
authors.affiliation: Department of Cardiology, CHU de Caen, Avenue cote de nacre, Caen, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Labombarda
authors.forename: Eva
authors.initials: E
authors.lastname: Zangl
authors.forename: Audrey Emmanuelle
authors.initials: AE
authors.lastname: Dugue
authors.forename: Dominique
authors.initials: D
authors.lastname: Bougle
authors.forename: Arnaud
authors.initials: A
authors.lastname: Pellissier
authors.forename: Virginie
authors.initials: V
authors.lastname: Ribault
authors.forename: Pascale
authors.initials: P
authors.lastname: Maragnes
authors.forename: Paul
authors.initials: P
authors.lastname: Milliez
authors.forename: Eric
authors.initials: E
authors.lastname: Saloux
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D007090:Image Interpretation, Computer-Assisted; D007333:Insulin Resistance / Q000502:physiology; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D063766:Pediatric Obesity / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology
chemical_list: D002097:C-Reactive Protein