Abstract 11447: Obesity-Related Arterial-Ventricular Stiffening Starts in Early Childhood
Background: Adulthood obesity is associated with increases in arterial, ventricular systolic, and ventricular diastolic elastance (stiffness). However, there is little information when arterial-ventricular stiffening begins to appear. To clarify this, we examined the relationship between body mass index (BMI) and arterial-ventricular stiffening and coupling from childhood to adolescence.
Methods: Echocardiography with tissue Doppler imaging was performed in 402 subjects aged 1 to 20 years. Subjects were divided into 3 age groups: preschool children group, 1 to 6 years (n = 133); school children group, 7 to 12 years (n = 161); and adolescents group, 13 to 20 years (n = 108). Left ventricular (LV) end-diastolic volume, LV mass, transmitral peak flow velocity (E), and mitral annular myocardial velocity (Em) were measured. LV mass/volume ratio was calculated. Stroke volume (SV) was measured using aortic diameter and pulsed Doppler velocity profile. SV was indexed for body surface area (SVI). Effective arterial elastance (Ea) was estimated by end-systolic pressure/SVI. End-systolic elastance (Ees) was calculated by a modified single-beat method using systolic and diastolic blood pressure, stroke volume, ejection fraction, timing intervals, and an estimated normalized ventricular elastance at arterial end diastole. Operant Ed was calculated from Doppler indices reflective of atrial pressures (E/Em) and the diastolic filling volume (SV).
Results: There were no significant relationships between BMI and Ea, Ees, and Ed in the pre-school children group. In the school children group, weak but significant correlations between BMI and Ea and Ees were found (r = 0.29, p < 0.01 and 0.17, p < 0.05, respectively), but Ed did not change with BMI. In the adolescents group, Ea, Ees, and Ed all increased significantly with BMI (r = 0.37, p < 0.01, 0.29, p < 0.01, and 0.20, p < 0.05, respectively). Arterial-ventricular coupling (Ea/Ees ratio) did not change with BMI in the 3 groups.
Conclusions: Obesity-related arterial-ventricular stiffening begins to appear in younger school children. Our findings suggest that primary prevention programs should be initiated in early childhood.
- © 2013 by American Heart Association, Inc.