Key result
Atherosclerosis risk factors in children are linked to significantly impaired left ventricular strain on 3DSTE.
Why the study?
Known risk factors for atherosclerosis such as dyslipidemia, hypertension, obesity, and fasting hyperglycemia are associated with subclinical myocardial dysfunction in children.
Is the presence of atherosclerosis risk factors associated with reduced left ventricular myocardial strain measured by 3DSTE in children?
Cross-Sectional (n=340)
Is the presence of atherosclerosis risk factors associated with reduced left ventricular myocardial strain measured by 3DSTE in children?
p-value: p=<0.01
3D speckle tracking echocardiography demonstrates that traditional atherosclerosis risk factors are associated with subclinical left ventricular myocardial dysfunction in children, which worsens with the accumulation of multiple risk factors.
May support early 3DSTE screening for subclinical dysfunction in at-risk children; leaves open need for prospective outcome studies.
BACKGROUND: The known risk factors for atherosclerosis such as dyslipidemia, hypertension, obesity, and fasting hyperglycemia are associated with subclinical myocardial dysfunction. We assessed myocardial strain in children who had risk factors for atherosclerosis with use of 3D speckle tracking echocardiography (3DSTE). METHODS: A total of 340 eligible children (mean age [±SD]: 9.5 [±1.9] years; range, 7.1-12.2; 189 males, 151 females). Levels of serum cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI) were investigated. The parameters of left ventricular (LV) myocardial strain including global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured with use of real time 3DSTE. RESULTS: Left ventricular (LV) global longitudinal strain and global circumferential strain in the groups with isolated dyslipidemia, isolated hypertension, isolated obese/overweight, and combination groups were lower than those in healthy controls (P < .01 for all). Global longitudinal strain (GLS) and GCS showed a negative correlation with the respective risk factors (TG, TC, and LDL-C; SBP and DBP; weight and BMI) (P < .05 for all). Multiple stepwise regression analysis showed a significant negative correlation of GLS and GCS with BMI, TC, TG, and SBP. The degree of myocardial strain aggravated significantly with increase in the number of risk factors in an individual subject.
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Zhang et al. (2018) conducted a cross-sectional in Risk factors for atherosclerosis (n=340). Risk factors for atherosclerosis (dyslipidemia, hypertension, obesity) vs. Healthy controls was evaluated on Left ventricular global longitudinal strain (GLS) and global circumferential strain (GCS) (p=<0.01). Children with risk factors for atherosclerosis had significantly lower left ventricular global longitudinal and circumferential strain compared to healthy controls (P<0.01).
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