Early detection of myocardial deformation by 2D speckle tracking echocardiography in normotensive obese children and adolescents.

Objective: To evaluate the left venticular myocardial deformation parameters in normotensive obese children and adolescents by using 2-D speckle tracking echocardiography.

Methods: This observational cross-sectional study included 69 children and adolescents (aged between 10-18), 38 were normotensive obese and 31 were normal weighted. All children underwent detailed two- dimentional, Doppler and two-dimentional speckle tracking echocardiography. Student t-test, Mann-Whitney U test, chi-square test and Pearson's correlation were used in statistical analysis. Multiple linear regression analysis was used the determine independent variables on global longitudinal strain (GLS).

Results: While in normal limits, diastolic blood pressure was significantly higher in obese group. Left ventricular end-diastolic diameter (LVDd) and end-systolic diameter (LVDs), interventricular septal thickness (IVSd), left ventricular posterior wall thickness (LPWD) and left ventricular mass index (LVM)/height(2.7) were significantly higher in obese group compared to healthy peers (p=0.004, p=0.011, p<0.001, p=0.001, p<0.001) respectively. Obese subjects had reduced global longitudinal strain (GLS) values (p=0.001). Multiple linear regression analysis using the stepwise method were performed to assess the independent variables (age, body mass index, insulin resistance, systolic blood pressure, diastolic blood pressure, left ventricular diameters and LVM index (g/m(2.7)) affecting the dependent variable GLS. GLS was found significantly correlated with body mass index (BMI) (β:0.440, p:0.001; 95% CI: 0.104-0.311).

Conclusion: Left ventricular strain parameters obtained by two dimentional speckle tracking echocardiography were diminished in obese children compared to normal subjects indicating that obesity in childhood is linked to decreased myocardial deformation even in the absence of comorbidities in early stages.