The impact of obesity on left ventricular mass and left ventricular systolic function in children

  • Ria Nova
  • Bambang Madiyono
  • Sudigdo Sastroasmoro
  • Damayanti R Sjarif
Keywords: childhood obesity, left ventricular mass, left ventricular systolic function

Abstract

Background Obesity causes cardiovascular disturbances. The
incidence of cardiovascular disease is higher even in mildly obese
patients than in lean subjects.
Objectives The purpose of this study was to compare left ven-
tricular (LV) mass, LV internal dimensions, and LV systolic func-
tion between obese and normal children; and to determine the as-
sociation of the degree of obesity with LV mass and LV systolic
function.
Methods This cross-sectional study was conducted on elemen-
tary school students in Jakarta from February to April 2003. We
measured the subjects’ body weight and height, and performed
lipid profile and echocardiography examinations. Measurements
of LV mass, LV internal dimensions with regard to septum thick-
ness, LV internal diameter, and LV posterior wall thickness; and
LV systolic function as indicated by shortening fraction and ejec-
tion fraction, were performed echocardiographically. The differ-
ences in measurements between obese and normal children as
well as between obese children with and without lipid abnormality
were analyzed. The correlation between the degree of obesity with
LV size and systolic function was determined.
Results Twenty-eight normal children and 62 obese children were
enrolled in the study. Mean LV mass was 35.7 (SD 5.16) g/cm 3 in
obese children versus 24.0 (SD 3.80) g/cm 3 in normal children
(P<0.0001). Mean septum thickness was 0.8 (SD 0.14) mm in
obese children versus 0.6 (SD 7.90) mm in normal children (P<
0.0001). Mean posterior wall thickness was 0.9 (SD 0.14) mm in
obese children versus 0.6 (SD 9.97) mm in normal children
(P<0.0001). Mean LV internal diameter was 4.0 (SD 0.34) mm in
obese children versus 3.9 (SD 0.29) mm in normal children
(P=0.300). There was strong correlation between the degree of
obesity and LV mass (r=0.838, P<0.0001). LV systolic function
(shortening fraction) was 37.1 (SD 4.20) percent in obese children
versus 35.8 (SD 4.99) percent in normal children (P=0.19). Ejec-
tion fraction was 67.4 (SD 5.32) percent in obese children versus
65.5 (SD 6.29) percent in normal children (P=0.13). There was
weak correlation between LV systolic function and the degree of
obesity (shortening fraction r=0.219, P=0.038; ejection fraction
r=0.239, P=0.023).
Conclusions Obese children had significantly greater LV mass,
septum thickness, and posterior wall thickness than normal chil-
Background
dren. Such significant difference was absent for LV internal diam-
eter and measures of LV systolic function. There was no signifi-
cant difference in LV mass and LV systolic function between obese
children with or without abnormality of lipid profile. A strong corre-
lation exists between the degree of obesity and LV mass, but the
correlation between degree of obesity and LV systolic function was
weak

Author Biographies

Ria Nova
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Bambang Madiyono
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Sudigdo Sastroasmoro
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.
Damayanti R Sjarif
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

References

1. Jousilahti P, Tuomilehto J, Vartiainen E, Pekkanen J,
Puska P. Body weight, cardiovascular risk factors and
coronary mortality. Fifteen year follow up of middle
aged men and women in eastern Finland. Circulation
1996;93:1372-9.
2. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath
CW. Body mass index and mortality in a prospective
cohort of U.S adults. N Engl J Med 1999;341:1097-
105.
3. Sheehan MT, Jensen MD. Metabolic complication of
obesity. Pathophysiologic considerations. Med Clin
North Am 2000; 84:363-79.
4. Morricone L, Malavazos AE, Coman C, Donati C,
Hassan J, Caviezel F. Echocardiographic abnormalities
in normotensive obese patients: relationship with vis-
ceral fat. Obesity Research 2002;10:489-98.
5. Karason K, Wallentin I, Larsson B, Sjostrom L. Effects
of obesity and weight: loss on left ventricular mass and
relative wall thickness: survey and intervention study.
BMJ 1997; 315:912-6.
6. Mitchell BM, Gutin B, Kapuku G, Barbeau P,
Humphries MC, Owen S, et al. Left ventricular struc-
ture and function in obese adolescent: relations to car-
diovascular fitness, percent body fat and visceral adi-
posity and effects of physical training. Pediatrics 2002;
109:1-11.
7. Alpert MA, Lambert CR, Panayiotou H, Terry BE,
Cohen MV, Massey CV, et al. Relation of duration of
morbid obesity to left ventricular mass, systolic func-
tion and diastolic filling and effect of weight loss. Am
J Cardiol 1995; 76:1194-7.
8. Alpert MA, Terry BE, Lambert CR, Kelly DL,
Panayiotou H, Mukerji V, et al. Factors influencing left
ventricular systolic function in nonhypertensive mor-
bidly obese patients and effect of weight loss induced
by gastroplasty. Am J Cardiol 1993; 71:733-7.
9. Kono Y, Yoshinaga M, Oku S, Nomura Y, Nakamura
M, Aihoshi S. Effect of obesity on echocardiographic
parameters in children. Int J Cardiol 1994; 46:7-13.
10. DeSimone G, Daniles SR, Devereux RB, meyer RA,
Roman MJ, Divitiis O, et al. Left ventricular mass and
body size in normotensive children and adults: assess-
ment of allometric relations and impact of overweight.
J Am Coll Cardiol 1992; 20:1251-60.
11. Nakajima T, Fujioka S, Tokunaga K, Hirobe K,
Matsuzawa Y, Tarui S. Noninvasive study of left ven-
tricular performance in obese patients: influence of
duration of obesity. Circulation 1985; 71:481-6.
Published
2016-10-10
How to Cite
1.
Nova R, Madiyono B, Sastroasmoro S, Sjarif D. The impact of obesity on left ventricular mass and left ventricular systolic function in children. PI [Internet]. 10Oct.2016 [cited 12Aug.2022];45(4):171-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/831
Section
Articles
Received 2016-10-08
Accepted 2016-10-08
Published 2016-10-10