Subtle Ventricular Dysfunction in Obese Children and Adolescents: Strain Imaging Study

Background: Obesity is a growing global health problem associated with increased cardiovascular risk. Echocardiographic strain imaging is a sensitive, noninvasive method for detecting early myocardial dysfunction. Aim: The aim of this work was to assess left ventricular (LV) and right ventricular (RV) function in obese children and adolescents using two-dimensional (2D) speckle-tracking strain. Patients and Methods: This case–control study was carried out on 76 children and adolescents, divided into two groups: Group 1 (patients): 38 obese children and adolescents and Group 2 (controls): 38 healthy children and adolescents. All participants were subjected to conventional echo and 2D speckle-tracking for assessment of LV longitudinal strain (apical two, three, and four) and RV longitudinal strain. Results: Patients had significantly higher body mass index (BMI) than controls. LV myocardial deformation was impaired, with significantly reduced global longitudinal strain (GLS) in the long-axis view and apical four-chamber view and lower total LV GLS ( P = 0.006). Significant reductions were also observed in the LV anterior wall basal segment and total anterior wall strain, as well as in RV septal wall basal, mid-segment, and total strain values. Among patients, age was positively correlated with LV GLS in the apical two-chamber view ( r = 0.38, P = 0.018), whereas BMI was negatively correlated with total LV GLS ( r = −0.311, P = 0.006). All other assessed parameters showed no significant differences or correlations ( P > 0.05). Conclusions: 2D speckle-tracking echocardiography detects subtle, early subclinical biventricular impairment in obese children, correlating with BMI. While not recommended for routine universal screening, it serves as a valuable adjunct for targeted long-term cardiovascular risk stratification in severe pediatric obesity.