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Childhood Obesity Increases Left-Ventricular Mass Irrespective of Blood Pressure Status

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Abstract

Adults with a left-ventricular mass index (LVMI) in grams normalized to height in meters2.7 (LVMI g/m2.7) >51 g/m2.7 are more prone to cardiovascular and cerebrovascular events. We delineated the odds for cardiac structural sequelae amongst apparently normal white and African-American (AA) children with varying body mass indices (BMI) and office blood pressures. A total of 2,071 children with normal echocardiograms were categorized into risk groups based on BMI and systolic blood pressures (SBPs). Predictors of cardiac sequelae examined were age, sex, race, and z-scores (z) for BMI, SBP, and diastolic blood pressure. Cardiac sequelae measures included (LVMI g/m2.7) >51 g/m2.7, (LVMI) (g/m2.7) z, left atrial size (LAht) (mm) z, and relative wall thickness z. Mean age was 14 ± 2 years with 56 % being male and 13 % being AA. Children were divided into “controls” (n = 1,059) and risk groups based on BMI and SBP. Odds ratio for LVMI (g/m2.7) > 51.0 g/m2.7, varied from 5.3 up to 8.5 in children with increased BMI. Both increased BMI and SBP z were associated with increased LVMI (g/m2.7) z; however, BMI z had a stronger association. Increased BMI z and AA race were associated with greater LAht (mm) z. AA controls had a nonsignificantly increased LVMI z and a significantly increased LAht (mm) and RWT z. Being overweight or obese is associated with cardiac sequelae in children to the extent known to be associated with adverse outcomes in adults. Healthy AA children have unique cardiac structural differences.

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Acknowledgments

Sarah Morrison Medical Student Research Grant 2010, University of Missouri, Kansas City-School of Medicine.

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Authors and Affiliations

  1. University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA

    A. M. Kharod & S. Kumar

  2. Harvard College, Harvard University, Cambridge, MA, USA

    T. Raghuveer

  3. Cardiology, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA

    S. R. Ramlogan, W. Drake, H. Dai & G. Raghuveer

Authors
  1. A. M. Kharod
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  2. S. R. Ramlogan
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  3. S. Kumar
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  4. T. Raghuveer
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  5. W. Drake
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  6. H. Dai
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  7. G. Raghuveer
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Correspondence to S. R. Ramlogan.

Appendices

Appendices

Appendix 1

See Table 2.

Table 2 Controls and risk groups
Full size table

Appendix 2

Devereux equation: LVMI = (0.81[1.04 (interventricular septal thickness + posterior wall thickness + LV end-diastolic dimension)3 − (LV end-diastolic dimension)3] + 0.6 LVMI (g/m2.7).

Appendix 3

See Fig. 3.

Fig. 3
figure 3

LVMI (g/m2.7) z, LAht (mm) z, and RWT z distributions in controls

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Appendix 4

See Table 3.

Table 3 LVMI (g/m2.7) and LAht (mm) percentiles for controls
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Appendix 5

See Tables 4, 5, and 6.

Table 4 Univariate and multivariate analysis for LVMI (g/m2.7) z
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Table 5 Univariate and multivariate analysis for LAht (mm) z
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Table 6 Univariate and multivariate analysis for RWT z
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Kharod, A.M., Ramlogan, S.R., Kumar, S. et al. Childhood Obesity Increases Left-Ventricular Mass Irrespective of Blood Pressure Status. Pediatr Cardiol 35, 353–360 (2014). https://doi.org/10.1007/s00246-013-0782-5

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  • DOI: https://doi.org/10.1007/s00246-013-0782-5

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