title: Relation of left atrial stiffness to insulin resistance in obese children: Doppler strain imaging study.
abstract: BACKGROUND
  The main objective of the study was to assess the strain measures (peak systolic longitudinal strain [LAS] and stiffness index [LASt]) and their relation to insulin resistance in obese children.
  
  
  RESULTS
  Eighty obese children (body mass index was 28.2 ± 3.1) and 60 age-matched healthy nonobese children were recruited. Conventional, tissue Doppler imaging LAS and LASt were measured for all children using 2D speckle tracking imaging (2DSI). Insulin resistance was assessed for obese children. Mean LAS was lower, and mean LASt was higher in obese children as compared to control group (11.3 + 2.2 vs. 38.2 + 11.6, P < 0.001, and 1.12 ± 0.23 vs. 0.21 ± 0.11, P < 0.001, respectively). LASt was significantly correlated with insulin resistance (P < 0.0001), and a value of >1.0 of LASt was the best cutoff value which can predict insulin resistance in obese children with a sensitivity of 92% and specificity of 86%.
  
  
  CONCLUSIONS
  LAS and LASt differed significantly in obese and nonobese children, in spite of normal left ventricular systolic and diastolic functions. LAS and LASt were associated with insulin resistance in obese children.
authors.affiliation: Cardiology Department, Zagazig University Hospital, Zagazig, Egypt.
authors.forename: Ragab A
authors.initials: RA
authors.lastname: Mahfouz
authors.affiliation: Cardiology Department, Zagazig University Hospital, Zagazig, Egypt.
authors.forename: Abdelaziz
authors.initials: A
authors.lastname: Gomma
authors.affiliation: Cardiology Department, Zagazig University Hospital, Zagazig, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Goda
authors.affiliation: Cardiology Department, Zagazig University Hospital, Zagazig, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Safwat
mesh_terms: D000293:Adolescent; D002648:Child; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D063766:Pediatric Obesity / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: insulin resistance; left atrial strain; obese children