Preclinical cardiovascular changes in children with obesity: A real-time 3-dimensional speckle tracking imaging study

Chunquan Zhang; Yiwen Deng; Yanna Liu; Yan Xu; Yanling Liu; Li Zhang; Xiongwen Chen; Mingxing Xie; Shuping Ge

doi:10.1371/journal.pone.0205177

Preclinical cardiovascular changes in children with obesity: A real-time 3-dimensional speckle tracking imaging study

PLoS One. 2018 Oct 11;13(10):e0205177. doi: 10.1371/journal.pone.0205177. eCollection 2018.

Authors

Chunquan Zhang¹, Yiwen Deng¹, Yanna Liu¹, Yan Xu¹, Yanling Liu², Li Zhang³, Xiongwen Chen⁴, Mingxing Xie³, Shuping Ge⁵

Affiliations

¹ Department of Ultrasound, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
² Department of Pediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
³ Department of Ultrasound, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
⁴ Department of Physiology, Temple University School of Medicine, Philadelphia, PA, United States of America.
⁵ The Heart Center, St. Christopher's Hospital for Children and Drexel University College of Medicine, Philadelphia, PA, United States of America.

Abstract

The aims of this study were (1) to quantify changes in 3-dimensional (3D) strain in obese children using real-time 3D echocardiography (RT3DE) and 3D speckle tracking echocardiography (3DSTE), and (2) to investigate the utility of left ventricular (LV) strain variables in measuring early cardiovascular changes in children with obesity. A total of 181 obese children (study group) aged 4-18 years old were prospectively enrolled and compared with 229 healthy subjects (control group). We acquired demographic, clinical, biochemical, and 2D echocardiography/Doppler data. Also, RT3DE and 3DSTE were performed to measure LV volume, left ventricular ejection fraction (LVEF), LV mass (LVM), LV peak systolic global longitudinal strain (GLS), radial strain (GRS), circumferential strain (GCS), and global strain (GS). There were significant differences in anthropometric measurements, blood pressures, Cholesterol, C-reactive protein (CRP), Intima-media thickness (IMT), left atrium end-systolic dimension (LASD), interventricular septal end-diastolic dimension (IVSD), LV posterior wall end-diastolic dimension (LVPWD), LV end-diastolic dimension (LVEDD), LV end-systolic dimension (LVESD), LV end-diastolic volumes (LVEDV), and LV end-systolic volumes (LVESV), E and A velocities, E/A,e', e'/a', E/e', LVM, LV mass index (LVMI), GLS, GRS, GCS, and GS between the study and control groups. The receiver operating characteristic curves (ROC) for the statistically significant echocardiographic variables showed that the range of areas of ROC curves varied from 0.76 (GLS), 0.74 (GRS), 0.72 (LASD), to 0.58 (LVESD), respectively. In conclusion, LV 3D strain variables by RT3DE and 3DSTE decrease in obese children. LV 3D strain is more sensitive than other echocardiographic and vascular ultrasound variables in detecting cardiovascular changes in children with obesity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adiposity
Adolescent
Blood Pressure
Child
Child, Preschool
Cholesterol / blood
Echocardiography* / methods
Female
Heart Ventricles / diagnostic imaging*
Heart Ventricles / physiopathology
Humans
Imaging, Three-Dimensional*
Male
Obesity / diagnostic imaging*
Obesity / physiopathology
Observer Variation
Organ Size
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Ventricular Function, Left*

Substances

Cholesterol

Grants and funding

This research received a grant from Jiangxi Province Department of Science and Technology (Grant number: 20152ACG70019). The grant provided salary support for 2 graduate students (YD and YX), but otherwise, the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.