Obesity-related cardiovascular behavior in children.

OBJECTIVE Obesity is a chronic metabolic disorder and may associate with cardiovascular geometrical, structural and functional changes. The aim of this study is to assess the relationship between body mass index (BMI), body surface area (BSA) and arterial-ventricular elasticity (Ea and Ees respectively) and cardiovascular coupling and myocardial wall stress and fiber stress in obese children. PATIENTS AND METHODS Sixty non-obese healthy children with BMI <85th percentile aged 6-17 years and 65 age and sex-matched children with BMI of ≥95th percentile, were included in the study. Beside cardiac systolic and diastolic functions, left verntricular (LV) systolic and diastolic dimensions and volumes (LVDs, LVDd, LVVs, LVVd respectively), LV mass (LVM), LV end-systolic pressure (LVESP), meridional end-systolic wall stress (ESWm), myocardial fiber stress (MFS), Midwall Shortening Fraction (SFmid), heart rate corrected circumferential fiber shortening (VCFc), predicted mid wall fiber shortening for a measured fiber stress (mid wall VCFc), right ventricular (RV) and LV work index (RVWI, LVWI), LV relative wall thickness (LVRWT), arterial elastance (Ea), LV end-systolic elastance (Ees) and end-systolic pressure volume relationship (ESPVR) were calculated. RESULTS LVDs and LVDd, LV mass (LVM), ESWSm, MFS, SF mid, Midwall VCFc and LVWI found to be significantly (p<0.001) higher, while Ea, Ees, ejection fraction (EF), fractional shortening (FS), VCFc-ESWS, RVWI, ESWSm/LVVs, LV end-systolic pressure (Pes)/LVVs and LVM/LVVd values were significantly (p<0.001) lower among obese group. By increasing age and BMI the Ea and Ees, ESWSm/LVVS and RVWI decrease; while LVDd, LVVd and stroke volume (SV) values increase. There was a reverse-relation between BMI percentiles and EF and FS.