Obese adolescents (especially with type 2 diabetes) had significantly higher myocardial extracellular volume fraction than healthy volunteers (median 0.376 vs 0.328 vs 0.264; P=0.0001).
Cross-Sectional (n=33)
Obese adolescents, particularly those with type 2 diabetes, exhibit subclinical myocardial tissue remodeling detectable by CMR extracellular volume fraction before overt changes in cardiac function or hypertrophy occur.
p-value: p=0.0001
BACKGROUND: Childhood obesity is a significant risk factor for cardiovascular disease in adulthood. Although ventricular remodeling has been reported in obese youth, early tissue-level markers within the myocardium that precede organ-level alterations have not been described. METHODS AND RESULTS: We studied 21 obese adolescents (mean age, 17.7±2.6 years; mean body mass index BMI, 41.9±9.5 kg/m(2), including 11 patients with type 2 diabetes T2D) and 12 healthy volunteers (age, 15.1±4.5 years; BMI, 20.1±3.5 kg/m(2)) using biomarkers of cardiometabolic risk and cardiac magnetic resonance imaging (CMR) to phenotype cardiac structure, function, and interstitial matrix remodeling by standard techniques. Although left ventricular ejection fraction and left atrial volumes were similar in healthy volunteers and obese patients (and within normal body size-adjusted limits), interstitial matrix expansion by CMR extracellular volume fraction (ECV) was significantly different between healthy volunteers (median, 0.264; interquartile range IQR, 0.253 to 0.271), obese adolescents without T2D (median, 0.328; IQR, 0.278 to 0.345), and obese adolescents with T2D (median, 0.376; IQR, 0.336 to 0.407; P=0.0001). ECV was associated with BMI for the entire population (r=0.58, P<0.001) and with high-sensitivity C-reactive protein (r=0.47, P<0.05), serum triglycerides (r=0.51, P<0.05), and hemoglobin A1c (r=0.76, P<0.0001) in the obese stratum. CONCLUSIONS: Obese adolescents (particularly those with T2D) have subclinical alterations in myocardial tissue architecture associated with inflammation and insulin resistance. These alterations precede significant left ventricular hypertrophy or decreased cardiac function.
Shah et al. (Wed,) conducted a cross-sectional in Adolescent obesity (n=33). Obesity (with or without type 2 diabetes) vs. Healthy volunteers was evaluated on Interstitial matrix expansion by CMR extracellular volume fraction (ECV) (p=0.0001). Obese adolescents (especially with type 2 diabetes) had significantly higher myocardial extracellular volume fraction than healthy volunteers (median 0.376 vs 0.328 vs 0.264; P=0.0001).
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