Background
Methods
Study population
Clinical assessment
CMR imaging
Cardiac remodeling
Ambulatory blood pressure monitoring
Statistics
Results
Demographics and clinical assessment
Obese/Overweight
n = 31 | Healthy
n = 37 |
p
*
| |
---|---|---|---|
Age (years) | 12.8 ± 2.5 12.5 [11.3, 14.3] | 13.4 ± 2.6 13.3 [12.1, 15.6] | 0.31 |
Sex (M/F) | 14/17 | 21/16 | 0.47 |
Weight (kg) | 75 ± 21 74 [56, 92] | 47 ± 13 49 [37, 56] |
<0.001
|
Height (cm) | 158 ± 13 157 [149, 165] | 156 ± 14 158 [147, 166] | 0.56 |
Body Mass Index (kg/m2) | 29 ± 6 29 [25, 33] | 19 ± 3 19 [18, 21] |
<0.001
|
Body Mass Index Percentile | 96 ± 4 98 [95, 99] | 47 ± 26 52 [27, 66] | |
Body Mass Index z-score | 2.0 ± 0.5 2.2 [1.7, 2.3] | −0.2 ± 0.9 0.1 [−0.6, 0.4] | |
Heart rate (beats/min) | 72 ± 9 | 70 ± 9 | 0.32 |
Systolic blood pressure (mmHg) | 117 ± 11 | 111 ± 8 |
0.001
|
Diastolic blood pressure (mmHg) | 75 ± 6 | 72 ± 5 | 0.07 |
Mean arterial pressure (mmHg) | 89 ± 7 | 85 ± 6 |
0.005
|
Cardiac remodeling
Obese/Overweight
n = 31 | Healthy
n = 37 |
p, age adjusted
| |
---|---|---|---|
LV geometry and function | |||
LV mass index (g/m2.7) | 27 ± 4 | 22 ± 3 |
<0.001
|
LV end-diastolic volume (mL) | 137 ± 29 | 125 ± 36 | 0.07 |
LV end-systolic volume (mL) | 51 ± 14 | 48 ± 15 | 0.25 |
LV mass/volume ratio | 0.69 ± 0.10 | 0.61 ± 0.06 |
<0.001
|
LV mean thickness (mm) | 5.6 ± 0.9 | 4.9 ± 0.7 |
<0.001
|
LV ejection fraction (%) | 63 ± 4 | 62 ± 4 | 0.44 |
LV remodeling | |||
LV hypertrophy score | 1.1 ± 2.2 | −0.96 ± 1.1 |
<0.001
|
LV remodeling types* |
<0.001
| ||
Normal geometry | 15 (49) | 31 (84) | |
Concentric remodeling | 1 (3) | 3 (8) | |
Eccentric hypertrophy | 4 (13) | 2 (5) | |
Concentric hypertrophy | 11 (35) | 1 (3) | |
RV geometry and function | |||
RV mass index (g/m2.7) | 7.9 ± 1.2 | 6.5 ± 1.0 |
<0.001
|
RV end-diastolic volume (mL) | 151 ± 37 | 141 ± 42 | 0.20 |
RV end-systolic volume (mL) | 59 ± 18 | 55 ± 20 | 0.37 |
RV ejection fraction (%) | 61 ± 6 | 61 ± 4 | 0.94 |
Blood pressure measurements
Obese/Overweight
n = 31 | Healthy
n = 37 |
p, age adjusted
| |
---|---|---|---|
24-h | |||
24 h SBP (mmHg) | 126 ± 15 | 117 ± 11 |
0.004
|
24 h DBP (mmHg) | 66 ± 8 | 64 ± 6 | 0.19 |
24 h systolic load (%) | 41 ± 28 | 22 ± 18 |
0.001
|
24 h diastolic load (%) | 19 ± 17 | 12 ± 11 |
0.04
|
Daytime | |||
Day SBP (mmHg) | 130 ± 15 | 123 ± 11 |
0.01
|
Day DBP (mmHg) | 70 ± 8 | 69 ± 7 | 0.58 |
Day systolic load (%) | 41 ± 28 | 23 ± 17 |
0.001
|
Day diastolic load (%) | 17 ± 16 | 13 ± 14 | 0.21 |
Nighttime | |||
Night SBP (mmHg) | 117 ± 17 | 107 ± 13 |
0.003
|
Night DBP (mmHg) | 59 ± 9 | 56 ± 6 |
0.046
|
Night systolic load (%) | 41 ± 31 | 20 ± 26 |
0.003
|
Night diastolic load (%) | 22 ± 24 | 13 ± 15 | 0.06 |
Nocturnal Dipping | |||
Systolic dipping (%) | 10 ± 6 | 13 ± 7 | 0.09 |
Diastolic dipping (%) | 15 ± 9 | 19 ± 8 | 0.07 |
Blood pressure classifications
Classification | Obese/Overweight
n = 31 | Healthy
n = 37 | Total
n = 68 |
---|---|---|---|
Normal | 11 (36) | 29 (79) | 40 (59) |
Masked hypertension | 10 (32) | 6 (16) | 16 (23) |
Pre-hypertension | 2 (6) | 2 (5) | 4 (6) |
Ambulatory hypertension | 8 (26) | 0 (0) | 8 (12) |
Correlations between blood pressure, obesity and cardiac remodeling
LVMI | LV Thickness | LV Mass/Volume | LV Hypertrophy score | |||||
---|---|---|---|---|---|---|---|---|
r
|
p
|
r
|
p
|
r
|
p
|
r
|
p
| |
BMI z-score | 0.62 | <0.001 | 0.49 | <0.001 | 0.43 | <0.001 | 0.58 | <0.001 |
Systolic | ||||||||
24 h SBP | 0.36 | 0.003 | 0.60 | <0.001 | 0.44 | <0.001 | 0.44 | <0.001 |
Day SBP | 0.39 | 0.001 | 0.57 | <0.001 | 0.41 | <0.001 | 0.45 | <0.001 |
Night SBP | 0.34 | 0.005 | 0.57 | <0.001 | 0.46 | <0.001 | 0.43 | <0.001 |
24 h systolic load | 0.33 | 0.006 | 0.43 | <0.001 | 0.36 | 0.003 | 0.37 | 0.002 |
Day systolic load | 0.34 | 0.005 | 0.37 | 0.002 | 0.32 | 0.007 | 0.36 | 0.003 |
Night systolic load | 0.31 | 0.01 | 0.44 | <0.001 | 0.39 | 0.001 | 0.36 | 0.003 |
Systolic dipping | −0.26 | 0.04 | ||||||
Diastolic | ||||||||
24 h DBP | 0.27 | 0.03 | ||||||
Night DBP | 0.24 | 0.046 | 0.31 | 0.01 | ||||
24 h diastolic load | 0.26 | 0.03 | 0.31 | 0.009 | ||||
Night diastolic load | 0.32 | 0.007 | 0.32 | 0.009 |
Multivariate linear regression
LVMI | LV Thickness | LV Mass/Volume | LV Hypertrophy Score | |||||
---|---|---|---|---|---|---|---|---|
β (SE)
|
p
|
β (SE)
|
p
|
β (SE)
|
p
|
β (SE)
|
p
| |
BMI z-score | 0.54 (0.10) | <0.001 | 0.34 (0.07) | <0.001 | 0.31 (0.10) | 0.004 | 0.47 (0.10) | <0.001 |
24 h SBP | 0.22 (0.10) | 0.03 | 0.36 (0.10) | <0.001 | ||||
Night SBP | 0.26 (0.08) | 0.001 | 0.35 (0.11) | 0.002 |