Impaired myocardial deformation and ventricular vascular coupling in obese adolescents with dysglycemia

Autor: Xiazhou Fan, Mary Craft, Anne Chun, Preneet Cheema Brar, Puneet Bhatla, Vivek Jani, Shelby Kutty
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Blood Glucose
Male
medicine.medical_specialty
Pediatric Obesity
lcsh:Diseases of the circulatory (Cardiovascular) system
Adolescent
Endocrinology
Diabetes and Metabolism
Speckle tracking echocardiography
Blood Pressure
Risk Assessment
Ventricular Function
Left
Ventricular Dysfunction
Left
Vascular Stiffness
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Humans
Mass index
Prospective Studies
Obesity
Longitudinal and circumferential strain and strain rate
Subclinical infection
Angiology
Glucose Metabolism Disorders
Original Investigation
Ejection fraction
Ventricular Remodeling
business.industry
Stroke Volume
Ventricular vascular coupling
medicine.disease
Prognosis
Abnormal glucose tolerance
Blood pressure
Cross-Sectional Studies
Echocardiography
lcsh:RC666-701
Case-Control Studies
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Biomarkers
Two-dimensional speckle-tracking echocardiography
Zdroj: Cardiovascular Diabetology, Vol 18, Iss 1, Pp 1-11 (2019)
Cardiovascular Diabetology
ISSN: 1475-2840
Popis: Background It is unknown that dysglycemia in obese adolescents has effects on myocardial deformation that are more pronounced when compared to obesity alone. We hypothesized that obesity associated abnormal glucose tolerance (dysglycemia) would have adverse effects on two-dimensional speckle tracking echocardiography derived longitudinal, radial and circumferential strain (LS, RS, CS) compared to age and gender lean controls. We also examined if changes in deformation would be reflected in abnormal ventricular vascular coupling indices (VVI). Methods In a prospective cross-sectional design 39 obese adolescents (15.9 ± 1.7 years; 101.5 ± 39 kg; female − 58%) were compared to age and gender matched lean controls (15.7 ± 1.8 yrs, 60 ± 12.8 kg). Based on results from an oral glucose tolerance test (OGTT), obese adolescents were categorized as obese normoglycemic (ONG, n = 25) or obese dysglycemic (ODG, n = 14). Left ventricular (LV) global and average LS, CS, RS and strain rate were measured. LV ejection fraction and mass index were measured and VVI approximated as ratio of arterial elasticity (Ea) and end-systolic elastance (Ees). Results Adolescents with ODG had significantly (P = 0.005) impaired global LS (− 20.98% ± 2.8%) compared to controls (− 23.01% ± 2.3%). A similar (P = 0.0027) reduction was observed in average LS for adolescents with ODG (18.87% ± 2.5%) compared to controls (20.49% ± 2%). Global CS was also decreased (P = 0.03) in ODG (− 23.95%) compared to ONG (− 25.80). A similar trend was observed in average CS after multivariate regression for BMI and blood pressure. CS correlated with HbA1c in both groups (P = 0.05). VVI had a negative correlation with both LS (r = − 0.4, P = 0.025) and CS rate (r = − 0.36, P = 0.04). Conclusions Myocardial strain and strain rate were significantly altered in obese adolescents. Unfavorable subclinical reductions in global and average CS were more pronounced in adolescents with dysglycemia compared to obese adolescents with normoglycemia and controls. These data indicate progressive worsening of subendocardial function across the spectrum of glucose tolerance. Strain rate was predictive of VVI in obese adolescents, suggesting strain rate may be a sensitive marker for cardiac remodeling in abnormal glucose homeostasis states.
Databáze: OpenAIRE
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