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Role of obesity and blood pressure in epicardial adipose tissue thickness in children. Pediatr Res 2022; 92:1681-1688. [PMID: 35322187 DOI: 10.1038/s41390-022-02022-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Elevated body mass index (BMI) has been associated with cardiac changes, such as higher epicardial adipose tissue (EAT) thickness. This fat has been identified as a predictive factor of cardiovascular diseases during adulthood. However, few studies have tested the association of multiple cardiovascular risk factors (high weight or blood pressure) with EAT in adolescents and children. Therefore, the main objective of this current research was to determine the impact of BMI, overweight, obesity, and blood pressure on EAT thickness in children. METHODS A descriptive cross-sectional study focused on elementary and high school students aged 6-16 years was carried out by utilizing diverse measurements and instruments, such as echocardiography. RESULTS EAT thickness (N = 228) was linked to sex (more predominant in boys 2.3 ± 0.6; p = 0.044), obesity (2.3 ± 0.6; p < 0.001), and hypertension (2.6 ± 0.6; p = 0.036). The logistic regression indicated that age, sex, and BMI seemed to be more relevant factors in EAT thickness in children (adjusted R square = 0.22; p < 0.001). CONCLUSIONS This paper examined the associations of sex, age, and cardiovascular risk factors (arthrometric measures and blood pressure) with EAT thickness, indicating that it is necessary to assess whether the findings are associated with future events. IMPACT Excessive weight gain and blood pressure in the early stages of life have been associated with adipose tissue. This increase in weight and blood pressure has been attributed to alterations in the epicardial adipose tissue linked to anthropometric markers in adults, but no related study has been implemented in Spanish children. This study revealed how higher epicardial adipose tissue is linked to body mass index, other anthropometric parameters, and blood pressure in Spanish children. These measurements are related to high epicardial adipose tissue thickness, which in early stages does not imply pathology but increases the risk of developing cardiovascular diseases.
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Loh DR, Tan RS, Lim WS, Koh AS. Cardio-sarcopenia: A syndrome of concern in aging. Front Med (Lausanne) 2022; 9:1027466. [PMID: 36388892 PMCID: PMC9640679 DOI: 10.3389/fmed.2022.1027466] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/11/2022] [Indexed: 07/22/2023] Open
Abstract
Cardiac alterations in structure and function, namely, the left ventricle, have been intensely studied for decades, in association with aging. In recent times, there has been keen interest in describing myocardial changes that accompany skeletal muscle changes in older adults. Initially described as a cardio-sarcopenia syndrome where alterations in myocardial structure were observed particularly among older adults with skeletal muscle sarcopenia, investigations into this syndrome have spurred a fresh level of interest in the cardiac-skeletal muscle axis. The purpose of this perspective is to summarize the background for this "syndrome of concern," review the body of work generated by various human aging cohorts, and to explore future directions and opportunities for understanding this syndrome.
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Affiliation(s)
- De Rong Loh
- Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
| | - Ru-San Tan
- Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
- National Heart Centre Singapore, Singapore, Singapore
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Angela S. Koh
- Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
- National Heart Centre Singapore, Singapore, Singapore
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Tinti MG, Scillitani A, Guglielmi G, Nieddu L, Carnevale V. Left Ventricular Mass and Parameters of Body Composition in Older Adults. Mayo Clin Proc 2022; 97:626-628. [PMID: 35246293 DOI: 10.1016/j.mayocp.2022.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/04/2022] [Indexed: 12/19/2022]
Affiliation(s)
- Maria Giulia Tinti
- Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Alfredo Scillitani
- Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Giuseppe Guglielmi
- Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | | | - Vincenzo Carnevale
- Unit of Internal Medicine, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
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Left Ventricular Geometrical Changes in Severely Obese Adolescents: Prevalence, Determinants, and Clinical Implications. Pediatr Cardiol 2021; 42:331-339. [PMID: 33079265 PMCID: PMC7907012 DOI: 10.1007/s00246-020-02487-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/08/2020] [Indexed: 12/17/2022]
Abstract
Left ventricular hypertrophy (LVH) is independently associated with a higher risk of cardiovascular morbidity and mortality in adults. Adiposity is a risk factor for LVH, independent of blood pressure. Potential causes of this nonhemodynamic pathogenesis identified in adults include adverse body fat distribution, insulin resistance, dyslipidemia, and obstructive sleep apnea syndrome (OSA). In severely obese adolescents, the determinants of obesity-induced changes in left ventricular structure are poorly characterized. Cardiac ultrasonographic, demographic, anthropometric, and comorbidity-related data were prospectively collected in adolescents with severe obesity refractory to conservative treatment who presented for surgical therapy. Differences between adolescents with LVH and without LVH were evaluated using independent samples t, chi-square, or Fisher's exact test. Multivariable linear regression analysis was performed to evaluate associations with left ventricular structural changes, corrected for body mass index (BMI) z score. Forty-three patients entered analysis, of whom 24 (55.8%) showed LVH. The most common geometrical change was eccentric LVH (eLVH), occurring in 21 subjects (48.8%). Demographic and anthropometric variables did not differ between patients with and without LVH. Independent of BMI z score, left ventricular mass index was significantly associated with apnea-hypopnea index (AHI) (regression parameter B = 0.8; 95% CI 0.3 to 1.2). Interventricular septum thickness (IVST) was significantly associated with HOMA-IR values (B = 0.1; 95% CI 0.04 to 0.2), HDL-cholesterol (B = - 1.2; 95% CI - 2.2 to 0.1), and triglyceride levels (B = 0.5; 95% CI 0.001 to 0.9). LVH, especially eLVH, is highly prevalent amongst severely obese adolescents. Adverse changes in cardiac structure, increased IVST in particular, are independently associated with several nonhemodynamic comorbidities that are common in this population, namely OSA, insulin resistance, and dyslipidemia.
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Lind L, Lampa E. Lifetime change in central and peripheral haemodynamics in relation to exercise capacity. Clin Physiol Funct Imaging 2019; 39:261-275. [PMID: 30920132 DOI: 10.1111/cpf.12570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/21/2019] [Indexed: 01/20/2023]
Affiliation(s)
- Lars Lind
- Department of Medical Sciences University Hospital Uppsala University Uppsala Sweden
| | - Erik Lampa
- Department of Medical Sciences University Hospital Uppsala University Uppsala Sweden
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La Merrill MA, Lind PM, Salihovic S, van Bavel B, Lind L. The association between p,p'-DDE levels and left ventricular mass is mainly mediated by obesity. ENVIRONMENTAL RESEARCH 2018; 160:541-546. [PMID: 29106953 PMCID: PMC6377158 DOI: 10.1016/j.envres.2017.10.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/24/2017] [Accepted: 10/18/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVES The pesticide metabolite p,p'-DDE has been associated with left ventricular (LV) mass and known risk factors for LV hypertrophy in humans and in experimental models. We hypothesized that the associations of p,p'-DDE with LV hypertrophy risk factors, namely elevated glucose, adiposity and hypertension, mediate the association of p,p'-DDE with LV mass. METHODS p,p'-DDE was measured in plasma from 70-year-old subjects (n = 988) of the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS). When these subjects were 70-, 75- and 80- years old, LV characteristics were measured by echocardiography, while fasting glucose, body mass index (BMI) and blood pressure were assessed with standard clinical techniques. RESULTS We found that p,p'-DDE levels were associated with increased fasting glucose, BMI, hypertension and LV mass in separate models adjusted for sex. Structural equation modeling revealed that the association between p,p'-DDE and LV mass was almost entirely mediated by BMI (70%), and also by hypertension (19%). CONCLUSION The obesogenic effect of p,p'-DDE is a major determinant responsible for the association of p,p'-DDE with LV mass.
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Affiliation(s)
- M A La Merrill
- Department of Environmental Toxicology, University of California, Davis, CA, USA.
| | - P M Lind
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - S Salihovic
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden; MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden, and Norwegian Institute for Water Research, NIVA, Oslo, Norway.
| | - B van Bavel
- MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden, and Norwegian Institute for Water Research, NIVA, Oslo, Norway.
| | - L Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden.
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Li QM, Li B, Sun YF, Zhang H, Yang XL, Cai LW, Chen H, Ding YH, Jiang J. Association of HLA-DRB1 single nucleotide polymorphisms with left ventricular remodelling in elderly patients with essential hypertension. J Int Med Res 2013; 40:2152-9. [PMID: 23321172 DOI: 10.1177/030006051204000613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the associations between human leucocyte antigen DRβ1 (HLA-DRB1) gene polymorphisms and cardiovascular remodelling (left ventricular dilatation [LVD]) in Han Chinese patients ≥ 60 years old, with essential hypertension. METHODS LVD was diagnosed via echocardiographic measurements. Multiplex polymerase chain reaction-ligase detection reaction was used to determine the genotypes of three HLA-DRB1 single nucleotide polymorphisms (SNPs; rs2308765, rs9269186 and rs3135388). RESULTS HLADRB1 rs2308765 wild-type (G) allele and genotype (GG) were associated with decreased risk of LVD. HLA-DRB1 rs9269186 and rs3135388 were not associated with LVD risk. Mean waist and abdominal circumferences were significantly larger in patients with, compared with those without, LVD. Multivariate logistic regression analyses found that rs2308765 was associated with LVD (GT + TT versus GG; odds ratio 7.958; 95% confidence interval 1.935, 32.723). CONCLUSIONS Mutation in HLA-DRB1 rs2308765 was associated with increased risk of LVD in elderly patients with hypertension. Genotype analysis may allow identification of patients at high risk of cardiovascular events such LVD.
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Affiliation(s)
- Q M Li
- First Hospital, Jilin University, Changchun, China
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Guerra F, Mancinelli L, Angelini L, Fortunati M, Rappelli A, Dessì-Fulgheri P, Sarzani R. The association of left ventricular hypertrophy with metabolic syndrome is dependent on body mass index in hypertensive overweight or obese patients. PLoS One 2011; 6:e16630. [PMID: 21304952 PMCID: PMC3031611 DOI: 10.1371/journal.pone.0016630] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2010] [Accepted: 12/26/2010] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Overweight (Ow) and obesity (Ob) influence blood pressure (BP) and left ventricular hypertrophy (LVH). It is unclear whether the presence of metabolic syndrome (MetS) independently affects echocardiographic parameters in hypertension. METHODS 380 Ow/Ob essential hypertensive patients (age ≤ 65 years) presenting for referred BP control-related problems. MetS was defined according to NCEP III/ATP with AHA modifications and LVH as LVM/h(2.7) ≥ 49.2 g/m(2.7) in males and ≥ 46.7 g/m(2.7) in females. Treatment intensity score (TIS) was used to control for BP treatment as previously reported. RESULTS Hypertensive patients with MetS had significantly higher BMI, systolic and mean BP, interventricular septum and relative wall thickness and lower ejection fraction than those without MetS. LVM/h(2.7) was significantly higher in MetS patients (59.14 ± 14.97 vs. 55.33 ± 14.69 g/m(2.7); p = 0.022). Hypertensive patients with MetS had a 2.3-fold higher risk to have LVH/h(2.7) after adjustment for age, SBP and TIS (OR 2.34; 95%CI 1.40-3.92; p = 0.001), but MetS lost its independent relationship with LVH when BMI was included in the model. CONCLUSIONS In Ow/Ob hypertensive patients MetS maintains its role of risk factor for LVH independently of age, SBP, and TIS, resulting in a useful predictor of target organ damage in clinical practice. However, MetS loses its independent relationship when BMI is taken into account, suggesting that the effects on MetS on LV parameters are mainly driven by the degree of adiposity.
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Affiliation(s)
- Federico Guerra
- Department of Internal Medicine and Cardiovascular Diseases, “Hypertension Excellence Centre” of the European Society of Hypertension, University Hospital “Ospedali Riuniti,” University “Politecnica delle Marche,” Ancona, Italy
| | - Lucia Mancinelli
- Department of Internal Medicine and Cardiovascular Diseases, “Hypertension Excellence Centre” of the European Society of Hypertension, University Hospital “Ospedali Riuniti,” University “Politecnica delle Marche,” Ancona, Italy
| | - Luca Angelini
- Department of Internal Medicine and Cardiovascular Diseases, “Hypertension Excellence Centre” of the European Society of Hypertension, University Hospital “Ospedali Riuniti,” University “Politecnica delle Marche,” Ancona, Italy
| | - Marco Fortunati
- Department of Internal Medicine and Cardiovascular Diseases, “Hypertension Excellence Centre” of the European Society of Hypertension, University Hospital “Ospedali Riuniti,” University “Politecnica delle Marche,” Ancona, Italy
| | - Alessandro Rappelli
- Department of Internal Medicine and Cardiovascular Diseases, “Hypertension Excellence Centre” of the European Society of Hypertension, University Hospital “Ospedali Riuniti,” University “Politecnica delle Marche,” Ancona, Italy
| | - Paolo Dessì-Fulgheri
- Department of Internal Medicine and Cardiovascular Diseases, “Hypertension Excellence Centre” of the European Society of Hypertension, University Hospital “Ospedali Riuniti,” University “Politecnica delle Marche,” Ancona, Italy
| | - Riccardo Sarzani
- Department of Internal Medicine and Cardiovascular Diseases, “Hypertension Excellence Centre” of the European Society of Hypertension, University Hospital “Ospedali Riuniti,” University “Politecnica delle Marche,” Ancona, Italy
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