title: Left ventricular diastolic function and cardiometabolic factors in obese normotensive children.
abstract: OBJECTIVE
  Left ventricular (LV) hypertrophy and diastolic function have been found to be associated with obesity and hypertension in adults. However, there are scarce data about the association of obesity itself to cardiac alteration in children. The aim of this study was to detect early changes in LV structure and function in obese children and whether they are associated with the biomarkers of metabolic risk and endothelial activation.
  
  
  RESULTS
  A total of 130 children aged 7-16 years (88 obese and 42 normal-weight children) were studied. All children had normal resting blood pressure. Two-dimensional ultrasound with M-mode imaging was performed to assess the LV mass index (LVMi), calculated as LV mass/height(2.7), and the peak diastolic of pulmonary venous flow velocity (PVFD). Tissue Doppler imaging was used to analyze ventricular performance through the ratio of the transmitral peak early filling velocity to the early average diastolic peak myocardial velocity (E/E'). The indicators of metabolic control, inflammation, and endothelial cell activation were evaluated. Compared to the controls, the obese subjects had significantly higher LVMi and E/E' and lower PVFD values, the two latest being found especially in severely obese subjects. In the multivariate analysis, the parameters of diastolic function (E/E' and PVFD) were independently associated with obesity, apolipoprotein A1, soluble vascular cell endothelial molecule-1 (sVCAM-1), and retinol-binding protein 4 (RBP4).
  
  
  CONCLUSIONS
  An echocardiographic evaluation of diastolic function is a useful tool to detect early cardiac changes in obese children. Emergent cardiovascular risk markers such as apolipoprotein A1, RBP4, and sVCAM-1 are associated with the parameters of diastolic function.
authors.affiliation: Department of Pediatrics, Dr. Peset University Hospital, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Porcar-Almela
authors.affiliation: Department of Pediatrics, Dr. Peset University Hospital, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain. Electronic address: pilar.codoner@uv.es.
authors.forename: P
authors.initials: P
authors.lastname: Codoñer-Franch
authors.affiliation: Department of Cardiology, Dr. Peset University Hospital, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Tuzón
authors.affiliation: Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Navarro-Solera
authors.affiliation: Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain; Department of Experimental Science, Catholic University of Valencia, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Carrasco-Luna
authors.affiliation: Department of Cardiology, Dr. Peset University Hospital, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ferrando
mesh_terms: D000293:Adolescent; D016632:Apolipoprotein A-I / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D009765:Obesity / Q000097:blood / Q000503:physiopathology*; D011446:Prospective Studies; D054839:Retinol-Binding Proteins, Plasma / Q000032:analysis; D012307:Risk Factors; D012995:Solubility; D013030:Spain / Q000453:epidemiology; D014463:Ultrasonography; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood / Q000737:chemistry; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D015415:Biomarkers; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; D019010:Vascular Cell Adhesion Molecule-1
keywords: Diastolic function; Left ventricular hypertrophy; Left ventricular mass; Metabolic risk factors; Obesity