Key result
Severe childhood obesity was associated with significantly reduced left atrial reservoir function (22.2% vs. 33.8%) and contractile function (5.4% vs. 13.3%) compared to children without obesity.
Why the study?
Although LV and RV remodeling and dysfunction are documented in severe obesity, less is known about left atrial dysfunction and its association with LV/RV remodeling, particularly in children.
Does severe obesity impair multichamber cardiac function assessed by MRI strain analysis in children?
Observational (n=45)
Does severe obesity impair multichamber cardiac function assessed by MRI strain analysis in children?
Severe childhood obesity is associated with early multichamber cardiac dysfunction, including impaired left atrial reservoir and contractile function, detectable by MRI strain analysis.
Answers are grounded in this paper and cite their sources.
May indicate early LA impairment in severe childhood obesity; hypothesis-generating for MRI strain monitoring, with no practice change warranted.
Background In severe obesity, left ventricular (LV) and right ventricular (RV) remodeling and contractile dysfunction have been documented, but less is known regarding left atrial (LA) dysfunction and its association with LV/RV remodeling, especially in children. Purpose To assess the effects of severe childhood obesity on cardiac function by using multichamber strain analysis with MRI. Study Type Prospective. Subjects Forty‐five children aged 7–18 years (including 20 with severe obesity, defined as a body mass index values above the 99th percentile). Field Strength 5 T. Sequence Steady‐state‐free‐precession (SSFP) images in short‐axis views and longitudinal two‐ and four‐chamber views. Assessment Cardiac strain measurements were derived from standard SSFP cine images by using a dedicated MR imaging feature tracking software. Inter‐ and intra‐rater reliability were evaluated. Statistical Tests Independent sample t test, Spearman's correlation coefficient, principal component analysis, Bland–Altman analysis, and intra‐class correlation coefficients (ICC). A P value <0.05 was considered statistically significant. Results As compared to children without obesity, those with obesity showed significantly reduced LA reservoir function (22.2% ± 6.4% vs. 33.8% ± 9.0%) and contractile function (5.4% ± 3.2% vs. 13.3% ± 8.0%) as well as significantly decreased absolute values for LA longitudinal strain in reservoir and contraction phases and LA radial motion fraction in reservoir and contraction phases. Children with severe obesity showed significantly reduced absolute RV radial motion fraction (−10.6% ± 2.9% vs. −18.2% ± 2.9%) and circumferential strain (−10.6% ± 2.9% vs. −16% ± 2.5%) as well as higher LV mass index (28.7% ± 5.1% vs. 21.7 ± 4.6 g/m 2 ) along with significantly reduced LV ejection fraction (56.4% ± 3.9% vs. 60% ± 4.1%), LV radial strain (56% ± 6% vs. 61.8% ± 11.3%), and longitudinal strain (−17.8% ± 1.8% vs. −20.3% ± 3.2%). Reliability was good to excellent, with ICC ranging from 79.1% to 97.7%. Data Conclusion MR feature‐tracking strain analysis revealed multichamber dysfunction in severely obese children with impaired LA reservoir and atrial contraction phases, which suggest an early loss in the compensatory ability of atrial contraction with severe obesity.
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Xu et al. (2021) conducted an observational in Severe obesity (n=45). Severe obesity vs. Children without obesity was evaluated on Left atrial reservoir function (p=<0.05). Severe childhood obesity was associated with significantly reduced left atrial reservoir function (22.2% vs. 33.8%) and contractile function (5.4% vs. 13.3%) compared to children without obesity.
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