Left ventricular structural changes and anthropometric markers of myocardial remodeling in overweight and obese children

Abstract

Objective . The aim of the study was to investigate the anthropometric correlates of left ventricular (LV) structural changes in school-age children (10–17 years old) with overweight and obesity in comparison with children of similar age with normal body weight living in St Petersburg. Design and methods. In the study, according to inclusion criteria, 112 children of 10–17 years old (71 boys) were included, the average age was 14,0 ± 2,1 years. Three groups were identified: 60 (54 %) children (41 boys) with obesity, 26 (23 %) children (16 boys) with overweight and 26 (23 %) children (14 boys) in the control group. All children underwent anthropometry (height and weight, head, chest, waist, thighs, wrist, shoulder, shin and hip circumference, lower segment length, umbilical point, leg length, head height) with calculation of body mass index (BMI), overweight percent, waistto-hip ratio and waist-to-height ratio. Echocardiography was performed according to a standard procedure with calculation of LV mass (LVM), LV mass index (LVMI). On the percentile tables grades of LVM and LVMI were allocated. The relative wall thickness was calculated, and the LV geometry phenotypes were determined. Results. Echocardiography LV dimensions (posterior wall thickness, interventricular septal thickness, diastolic and systolic LV diameter), as well as LVM and LVMI were higher in obese children compared to control group children. LV hypertrophy (LVH) developed in 42,3 % overweight children and in 58,3 % obese children. Normal LV geometry was found in 73,1 % children with normal body weight, concentric remodeling — in 19,2 % cases, and 7,7 % children had eccentric LVH. In the overweight children group, normal LV geometry was determined in 34,5 %, concentric remodeling — in 7,7 %, concentric LVH — in 19,2 %, and eccentric LVH — in 38,6 %. In obese children, the distribution of various types of LV remodeling was as follows: 23,3 % / 3,3 % / 15 % / 58,4 %, respectively. We found a stronger correlation between LVM and body surface area, thigh circumference and shoulder circumference, and LVMI with BMI, overweight percent, shoulder circumference and lower segment length. The waist circumference is less associated with LVH in children. Conclusions. Since childhood, overweight and obesity are risk factors for LVH and the development of various LV geometry phenotypes. Anthropometric markers of myocardial remodeling is an affordable way of early cardiovascular risk stratification in overweight and obese children.