Left ventricular remodelling and vascular adaptive changes in adolescents with obesity

Summary Background The aim of this study was to determine the effects of obesity on myocardial mechanics and ventriculo‐arterial coupling (V‐A) in children. Methods Strain parameters, stroke volume, arterial elastance, left ventricular (LV) elastance and V‐A were compared after adjusting for age and hypertension and after multivariate sub‐group analysis between patients with and without obesity. Results Among 123 retrospectively enrolled subjects, 6–21 years age, 79.7% males, 52% were obese. Median (range) Body Mass Index Z score was +2.35 (1.67–4.43) for obese and +0.68 (−2.48–1.63) for non‐obese. Subjects with obesity had higher LV mass indexed2.7 (LVMI2.7) compared with non‐obese (P < 0.001). Lower global longitudinal strain (GLS) (P = 0.012), global circumferential strain (GCS) (P = 0.004), average longitudinal strain rate (P = 0.002) and average circumferential strain rate (P < 0.001) were seen in subjects with obesity; no difference was noted in arterial elastance, LV end systolic elastance and V‐A. Increased LVMI2.7, decreased GLS, GCS, average longitudinal strain rate, average circumferential strain rate and maintained V‐A were noted in the multivariate analysis between subgroups. Conclusions Obesity causes alterations in myocardial mechanics with preserved V‐A in children. These findings may aid intervention in preventing the long‐term cadiovascular effects of obesity.