Obesity is a risk factor for cardiovascular morbidity and mortality that has deleterious effects on cardiovascular function. The aim of this work was to screen early cardiovascular abnormalities in obese asymptomatic adolescents using Conventional Echocardiography and Electrocardiogram. Fifty asymptomatic obese adolescents selected from National Heart Institute were compared to fifty non-obese normal controls with mean age of (12.44 ± 1.91) and (11.99 ± 1.89) years respectively. All studied adolescents were subjected to: careful history taking, complete clinical examination, laboratory investigation: fasting blood glucose, lipid profile, fasting insulin, insulin resistance, echocardiography and ECG. Results: It revealed statistical significant differences between obese and non-obese groups regarding left ventricle septal wall in diastole (LVSd), posterior wall thickness in diastole (LVPWd), relative wall thickness (RWT), LV end diastolic and systolic diameter (LVEDD and LVESD) and LV mass (P-value: 0.000). The left atrial dimensions (LA) were also significantly higher in the obese subjects than in the control group (P-value: 0.000). For the Doppler measurements, the early and late mitral valve velocity and the ratio between them (MVE velocity, MVA velocity and MV E/A) were significantly higher in obese than control subjects (P-value: 0.000). A strong positive correlation was noted between BMI and left atrial size (P-value: 0.003), left ventricular septum in diastole (LVSd) (P-value: 0.000), LVEDD (P-value: 0.005) and LVESD (P-value: 0.000), posterior wall thickness in diastole (LVPWd) (P-value: 0.012), left ventricle septal wall in diastole (LVSd) (P-value: 0.000) and left ventricular mass (P-value: 0.010). Conclusion: This study demonstrated that asymptomatic obese adolescents had significant changes in left ventricular dimensions and early diastolic filling compared to non-obese subjects.
Cite this paper
Mohamed, H. H. , El-Ghany, S. M. A. , Khairy, S. A. , Ahmed, E. A. and Emam, A. M. A. (2021). Study of Cardiovascular Changes in Adolescents with Simple Obesity. Open Access Library Journal, 8, e7365. doi: http://dx.doi.org/10.4236/oalib.1107365.
Cardel, M.I., Atkinson, M.A., Taveras, E.M., Holm, J.-C. and Kelly, A.S. (2020) Obesity Treatment Among Adolescents: A Review of Current Evidence and Future Directions. JAMA Pediatrics, 174, 609-617.
https://doi.org/10.1001/jamapediatrics.2020.0085
Okpara, I.C., Adediran, O.S., Odia, O.J. and Uchenna, D.I. (2010) The Relationship Between Measures of Obesity and Echocardiographic Determinants of Left Ventricular Hypertrophy in Nigerian Adults. The Internet Journal of Cardiology, 9, 1-9.
Saltijeral, A., Perez de Isla, L. and Zamorano, J. (2011) Obesity Cardiomyopathy in Children. Journal of the ESC Council for Cardiology Practice, 10, 157.
O’Neil, B.J., Hoekstra, J., Pride, Y.B., Lefebvre, C., Diercks, D., Frank Peacock, W., et al. (2010) Incremental Benefit of 80-Lead Electrocardiogram Body Surface Mapping over the 12-Lead Electrocardiogram in the Detection of Acute Coronary Syndromes in Patients without ST-Elevation Myocardial Infarction: Results from the Optimal Cardiovascular Diagnostic Evaluation Enabling Faster Treatment of Myocardial Infarction (OCCULT MI) Trial. Academic Emergency Medicine, 17, 932-939.
https://doi.org/10.1111/j.1553-2712.2010.00848.x
Santoro, N., del Giudice, E.M., Grandone, A., Marzuillo, P., Cozzolino, D., Di Salvo, G., et al. (2008) Y2 Receptor Gene Variants Reduce the Risk of Hypertension in Obese Children and Adolescents. Journal of Hypertension, 8, 1590-1594.
https://doi.org/10.1097/HJH.0b013e32830413ed
National Institute for Health and Clinical Excellence (2006) Clinical Guideline 43; Obesity: The Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. National Institute for Health and Clinical Excellence, London.
World Health Organization (1995) Physical Status. The Use and Interpretation of Anthropometr. Report of a WHO Expert Committee. Technical Report Series No. 854, World Health Organization, Geneva, 268-329.
Kuczmarski, R.J., Ogden, C.L., Guo, S.S., Grummer-Strawn, L.M., Flegal, K.M., Mei, Z., Wei, R., Curtin, L.R., Roche, A.F. and Johnson, C.L. (2002) Growth Charts for the United States: Methods and Development. United States Vital Statistics, No. 246, 1-190.
Werner, W., Rey, H.G. and Wielinger, H. (1970) über die Eigenschaften eines neuen Chromogens für die Blutzuckerbestimmung nach der GOD/POD-Methode: On the Properties of a New Chromogen for the Determination of Glucose in Blood According to the GOD/POD-Method. Fresenius’ Zeitschrift Für Analytische Chemie, 52, 224-228. https://doi.org/10.1007/BF00546391
Boehm, T.M. and Lebovitz, H.E. (1979) Statistical Analysis of Glucose and Insulin Responses to Intravenous Tolbutamide: Evaluation of Hypoglycemic and Hyperinsulinemic States. Diabetes Care, 2, 479-490. https://doi.org/10.2337/diacare.2.6.479
Trinder, P. and Webster, D. (1984) Determination of HDL Cholesterol Using 2, 4, 6-Tribromo-3-Hydroxybenzoic Acid with a Commercial CHOD-PAP Reagent. Annals of Clinical Biochemistry, 21, 430-433.
https://doi.org/10.1177%2F000456328402100516
Lang, R.M., Bierig, M., Devereux, R.B., Flachskampf, F.A., Foster, E., Pellikka, P.A., et al. (2005) Recommendations for Chamber Quantification. Journal of the American Society of Echocardiography, 12, 1440-1463.
https://doi.org/10.1016/j.echo.2005.10.005
Niadorf, S.M., Picard, M.H., Triulzi, M.O., Thomas, J.D., Newell, J., Etta King, M., et al. (1992) New Perspectives in the Assessment of Cardiac Chamber Dimensions during Development and Adulthood. Journal of the American College of Cardiology, 19, 983-988. https://doi.org/10.1016/0735-1097(92)90282-R
Nishimura, R.A. and Tajik, A.J. (1997) Evaluation of Diastolic Filling of Left Ventricle in Health and Disease: Doppler Echocardiography Is the Clinician’s Rosetta Stone. Journal of the American College of Cardiology, 30, 8-18.
https://doi.org/10.1016/S0735-1097(97)00144-7
American Society of Echocardiography Committee on Standards and Subcommittee on Quantitation of Two-Dimensional Echocardiograms (1989) Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography. Journal of the American Society of Echocardiography, 2, 358-367.
https://doi.org/10.1016/S0894-7317(89)80014-8
Lateva, M., Bliznakova, D., Galcheva, S., Bocheva, Y., Neshkinska, M., Mladenov, V., Halvadzhiyan, I., Yordanova, G., Boyadzhiev, V., Yotov, Y. and Conev, N. (2017) Childhood Obesity, Renal Injury and Future Disease Risk. Scripta Scientifica Medica, 49, 38-46. https://doi.org/10.14748/ssm.v49i1.2050
Wardle, J., Brodersen, N.H., Cole, T.J., Jarvis, M.J. and Boniface, D.R. (2006) Development of Adiposity in Adolescence: Five Year Longitudinal Study of an Ethnically and Socioeconomically Diverse Sample of Young People in Britain. BMJ, 332, 1130-1135. https://doi.org/10.1136/bmj.38807.594792.AE
Van Putte-Katier, N., Rooman, R.P., Haas, L., Verhulst, S.L., Desager, K.N., Ramet, J. and Suys, B.E. (2008) Early Cardiac Abnormalities in Obese Children: Importance of Obesity per se versus Associated Cardiovascular Risk Factors. Pediatric Research, 64, 205-209. https://doi.org/10.1203/PDR.0b013e318176182b
Kibar, A.E., Pac, F.A., Oflaz, M.B., Balli, S. and Ece, I. (2012) Echocardiographic Evaluation of Left Ventricular Function in Normotensive Obese Children: A Comparative Analysis According to Body Mass index. Archives of the Turkish Society of Cardiology, 40, 337-346. https://doi.org/10.5543/tkda.2012.49344
Li, X., Li, S., Ulusoy, E., Chen, W., Srinivasan, S.R. and Berenson, G.S. (2004) Childhood Adiposity as a Predictor of Cardiac Mass in Adulthood: The Bogalusa Heart Study. Circulation, 110, 3488-3492.
https://doi.org/10.1161/01.CIR.0000149713.48317.27
Deng, Y., Alharthi, M.S., Thota, V.R., Yin, L., Li, C. and Emani, U.R., Chandrasekaran, K., Khandheria, B. and Mookadam, F. (2010) Evaluation of Left Ventricular Rotation in Obese Subjects by Velocity Vector Imaging. European Journal of Echocardiography, 11, 424-428. https://doi.org/10.1093/ejechocard/jep230
Levy, D., Garrison, R.J., Savage, D.D., Kannel, W.B. and Castelli, W.P. (1990) Prognostic Implications of Echocardiographically Determined Left Ventricular Mass in the Framingham Heart Study. New England Journal of Medicine, 322, 1561-1566. https://doi.org/10.1056/NEJM199005313222203
Alpert, M.A. (2001) Obesity Cardiomyopathy: Pathophysiology and Evolution of the Clinical Syndrome. American Journal of the Medical Sciences, 321, 225-236.
https://doi.org/10.1097/00000441-200104000-00003
Franssen, W.M.A., Beyens, M., Al Hatawe, T. and Frederix, I. (2018) Cardiac Function in Adolescents with Obesity: Cardiometabolic Risk Factors and Impact on Physical Fitness. International Journal of Obesity, 43, 1400-1410.
https://doi.org/10.1038/s41366-018-0292-x
Mehta, S.K., Holliday, C., Hayduk, L., Wiersma, L., Richards, N. and Younosazi, A. (2004) Comparison of Myocardial Function in Children with Body Mass Indexes ≥25 versus Those <25 kg/m2. American Journal of Cardiology, 93, 1567-1569.
https://doi.org/10.1016/j.amjcard.2004.03.016