Analysis of Right Atrial Function in Obese Pediatric Patients

Abstract

Background : Left atrial enlargement and right and left ventricular dysfunction have been described in obese Patients. A number of studies have also described atrial dysfunction in obese children and adolescents. Objective: The aim of the present study was to investigate right atrial dysfunction in obese pediatric patients and Compare echocardiography findings between these patients and non-obese controls. Methods : Doppler echocardiography was performed on 50 obese pediatric patients (mean BMI=29.8 kg/m2) and 46 lean healthy controls. Systolic and diastolic function in both ventricles was investigated through conventional Doppler echocardiography. Right atrial function was evaluated using Color Doppler Myocardial Imaging (CDMI). Results: No differences were detected between groups with regard to left ventricular ejection fraction. The S wave of the free Wall of the right ventricle was similar in both groups (13.8 ± 1.7 vs. 13.7 ± 1.6, p=0.655). The e’/A’ ratio in the right Ventricle was significantly lower in the obese patients (0.9 ± 0.4 vs.1.2 ± 0.3, p=0.007). CDMI analysis of the right atrium and inter-atrial septum showed significantly lower, strain and strain rate in obese patients (82.6 ± 29.8 vs. 98.6 ± 38.7, p=0.020; 3.9 ± 1.0 vs. 4.4 ± 1.2, p<0.001; 50.9 ± 25.0 vs. 81.1 ± 21.6, p<0.001; and 2.2 ± 1.0 vs. 3.3 ± 0.8, p<0.001, respectively). Conclusion: The findings of the present study suggest incipient right atrial dysfunction, which may be secondary to an incipient impairment of myocardial relaxation in the right ventricle in obese children (BMI above 95th percentile).