Associations of childhood and adult obesity with left ventricular structure and function.

Abstract

Background Overweight and obesity are associated with left ventricular (LV) dysfunction. We sought whether echocardiographic evidence of abnormal adult cardiac structure and function was related to childhood or adult adiposity. Methods This study included 159 healthy individuals aged 7-15 years and followed until age 36-45 years. Anthropometric measurements were performed both at baseline and follow-up. Cardiac structure (indexed left atrial volume [LAVi], left ventricular mass [LVMi]) and LV function (global longitudinal strain [GLS], mitral e’) were assessed using standard echocardiography at follow up. Conventional cut-offs were used to define abnormal LAVi, LVMi, GLS and mitral annular e’. Results Childhood body mass index (BMI) was correlated with LVMi (r=0.25, p=0.002), and child waist circumference was correlated with LVMi (r=0.18, p=0.03) and LAVi (r=0.20, p=0.01), but neither were correlated with GLS. One standard deviation (by age and sex) increase in childhood BMI was associated with LV hypertrophy (RR: 2.04 [95% CI: 1.09, 3.78]) and LA enlargement (RR: 1.81 [95% CI: 1.02, 3.21]) independent of adult BMI, but the association was not observed with impaired GLS or mitral e’. Cardiac functional measures were more impaired in those who had normal BMI as child but had high BMI in adulthood (p&lt;0.03), and not different in those who were overweight or obese as a child and remained so in adulthood (p&gt;0.33). Conclusions Childhood adiposity is independently associated with structural cardiac disturbances (LVMi and LAVi). However, functional alterations (GLS and mitral e’) were more frequently associated with adult overweight or obesity, independent of childhood adiposity.</p

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