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Impact of obesity on diastolic function in subjects < or = 16 years of age.

Sharpe JA, Naylor LH, Jones TW, Davis EA, O'Driscoll G, Ramsay JM, Green DJ

Department of Cardiology, Princess Margaret Hospital, Subiaco, Australia.

The aim of this study was to investigate the impact of obesity on diastolic function in children and adolescents. Echocardiographic measurements were compared in 28 obese subjects (14 males, 14 females) and 15 age- and gender-matched lean controls (8 males, 7 females). Two-dimensional ultrasound imaging, M-mode imaging, and pulse-wave conventional and tissue Doppler measurements were used to assess cardiac structure and function at rest. No differences were evident between lean and obese subjects in age (13.3 +/- 0.5 vs 12.4 +/- 0.4 years), height (163 +/- 4 vs 159 +/- 2 cm), or systolic blood pressure (119 +/- 3 vs 123 +/- 2 mm Hg). Body mass (54.6 +/- 4.0 vs 85.8 +/- 3.6 kg, p < 0.0001) and body mass index (20.5 +/- 0.7 vs 33.3 +/- 1.0 kg/m2, p < 0.00001) were significantly greater in the obese subjects, whereas measurements of wall thickness (interventricular septal wall 0.86 +/- 0.04 vs 0.89 +/- 0.02 cm, posterior wall 0.83 +/- 0.04 vs 0.91 +/- 0.02 cm) and fractional shortening (38.6 +/- 1.2% vs 38.8 +/- 1.2%) did not significantly differ. The E/E' ratio (6.86 +/- 0.20 vs 8.30 +/- 0.32, p < 0.01), E' (13.93 +/- 0.38 vs 12.29 +/- 0.44 cm/s, p < 0.05), the E'/A' ratio (2.49 +/- 0.17 vs 2.05 +/- 0.09, p < 0.05), and the deceleration time of early transmitral blood flow velocity (125.3 +/- 7.7 vs 154.5 +/- 6.8 ms, p < 0.01) were significantly different between the groups, suggesting reduced diastolic function in the obese subjects. In conclusion, these data suggest that indexes of diastolic function, including tissue Doppler measures, are significantly impaired in obese young subjects.

Published 22 August 2006 in Am J Cardiol, 98(5): 691-3.
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