Abstract 21217: Cardiovascular Impact of Obesity Epidemic on Children with Congenital Heart Disease
The prevalence of overweight and obese children has tripled in one generation's time; 31.9% of US children and adolescents are overweight. Higher body mass index (BMI) is associated with higher left ventricular (LV) mass. Recent reports show increased rates of obesity in children with congenital heart disease. Little is known about the impact of obesity on the hearts of children with congenital heart disease. We evaluated secular changes in BMI and LV mass in children with repaired congenital heart disease (CHD).
Methods: All patients between 2-19 years of age who underwent echocardiography from 1990 to 2010 at Cincinnati Children's Hospital Medical Center 3 months or greater after surgical repair or device closure of simple atrial or ventricular septal defects were included. To control for age, z-scores were calculated for both BMI and LV mass indexed to height raised to a power of 2.7 (LVMI). Comparison was made to healthy controls.
Results: A total of 439 subjects with CHD were studied in the 21-year period. There was a nearly linear rise in mean BMI z-score and LVMI z-score over time (y = 0.0587x - 0.4555, R2 = 0.5348 and y = 0.0286x - 0.0475, R2 = 0.2879, respectively). Regression formulae estimate an increase in average BMI z-score from -0.46 to +0.78 (net increase +1.24) over the study period (vs an increase from +0.0 to +1.37, net +1.37 in controls) and an increase in LVMI z-score from -.05 to +0.55 (net +0.60, vs an increase from -0.2 to 0.0, net +0.2 in controls).
Conclusions: Today's children with common congenital heart defects have higher BMI and higher indexed LV mass than their counterparts a generation ago, similar to trends in healthy children. The full extent of cardiovascular effects of the obesity epidemic on children who have undergone open heart surgery or catheter-based intervention remains unknown. Additional research is required to understand the impact of obesity and overweight on the long-term outcome and cardiovascular health of children with CHD.
- © 2010 by American Heart Association, Inc.