Left ventricular mass and diastolic function in obese children and adolescents.

Background: Our aims were to assess left ventricular structure and diastolic function in obese subjects stratified according to ambulatory blood pressure status, and to investigate independent predictors of the left ventricular mass (LVM) index.

Methods: Obese subjects aged 9-19 years referred for ambulatory blood pressure monitoring (ABPM) were evaluated in the cross-sectional study. In addition to biochemical and anthropometric measurements, subjects underwent ABPM, Doppler echocardiography, and treadmill exercise test.

Results: According to ABPM results, 103 subjects with obesity (mean age 14.1 ± 2 years) were split in two groups: 49 hypertensive, and 54 without hypertension. Left ventricular hypertrophy was found in 16.3 % of hypertensive, and 5.6 % of normotensive. Variables included in stepwise regression analysis as potential determinants of LVM index were age, body mass index z score, waist circumference, peak systolic blood pressure on exercise test, 24-h heart rate, and night heart rate. Peak systolic blood pressure (adjusted R(2) = 0.051, β = 0.245, p = 0.013) remained as the independent predictor of LVM index. Diastolic function evaluated by mitral E/A ratio was decreased in both obese groups.

Conclusions: Early markers of cardiac disease including hypertrophy and diastolic dysfunction of the left ventricle are present in youths with obesity prior to the development of sustained hypertension.