Pediatr Nephrol (2015) 30:645–652 DOI 10.1007/s00467-014-2992-3

ORIGINAL ARTICLE

Left ventricular mass and diastolic function in obese children and adolescents Paripović Dušan & Ilisić Tamara & Vukomanović Goran & Miloševski-Lomić Gordana & Peco-Antić Amira

Received: 15 September 2014 / Revised: 13 October 2014 / Accepted: 14 October 2014 / Published online: 30 October 2014 # IPNA 2014

Abstract Background Our aims were to assess left ventricular structure and diastolic function in obese subjects stratified according to ambulatory blood pressure status, and to investigate independent predictors of the left ventricular mass (LVM) index. Methods Obese subjects aged 9–19 years referred for ambulatory blood pressure monitoring (ABPM) were evaluated in the cross-sectional study. In addition to biochemical and anthropometric measurements, subjects underwent ABPM, Doppler echocardiography, and treadmill exercise test. Results According to ABPM results, 103 subjects with obesity (mean age 14.1±2 years) were split in two groups: 49 hypertensive, and 54 without hypertension. Left ventricular hypertrophy was found in 16.3 % of hypertensive, and 5.6 % of normotensive. Variables included in stepwise regression analysis as potential determinants of LVM index were age, body mass index z score, waist circumference, peak systolic blood pressure on exercise test, 24-h heart rate, and night heart rate. Peak systolic blood pressure (adjusted R2 =0.051, β= 0.245, p=0.013) remained as the independent predictor of LVM index. Diastolic function evaluated by mitral E/A ratio was decreased in both obese groups. Conclusions Early markers of cardiac disease including hypertrophy and diastolic dysfunction of the left ventricle are P. Dušan (*) : M.51 g/m2.7 [12]. Relative wall thickness (RWT) was calculated to investigate the left ventricular geometry. RWT was considered elevated if ≥0.36 [13]. The subjects were divided into four groups based on LVM index and RWT: normal geometry (normal LVM index and RWT), concentric remodeling (normal LVM index and increased RWT), eccentric LVH (increased LVM index and normal RWT) or concentric LVH (increased LVM index and RWT). Left ventricular diastolic function was assessed by classic pulsed-wave Doppler technique. Mitral inflow velocities were obtained in the apical four-chamber view. The measurements of early diastolic peak flow velocity (E), E wave deceleration time (DT), late diastolic peak flow velocity (A), E/A ratio, and the isovolumic relaxation time (IVRT) were determined. Anthropometric measurements Body weight was measured with a digital device to the nearest 0.1 kg, and height was measured with a stadiometer to the nearest 0.1 cm. The body mass index (BMI) was calculated as the weight in kilograms divided by the square of the height in meters. Obesity was defined as a BMI ≥95th percentile, while BMI z score values were computed based on subject age and

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gender by using the Cole’s least square model [14]. Waist circumference was measured at the midpoint between the ribs and the superior iliac crest at the end of expiration while the subjects were in a standing position. The physical examination included an assessment of pubertal stage and classification into the two categories of prepubertal and pubertal according to the criteria of Tanner [15].

between LVM index and RWT. Statistical significance was assumed at p

Left ventricular mass and diastolic function in obese children and adolescents.

Our aims were to assess left ventricular structure and diastolic function in obese subjects stratified according to ambulatory blood pressure status, ...
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