Abstract 5714: Influence of Body Mass Index on Early Diastolic Untwisting Velocity in Healthy Children

Background: Childhood obesity is increasingly prevalent in the community and is predictive of adverse cardiovascular outcomes in adulthood. We hypothesised that increased body mass index (BMI) in children has an adverse influence on left ventricular (LV) untwisting, a sensitive marker of LV function that reflects a key process in the transition between LV relaxation and suction. Methods: Cardiac structure and function were assessed by transthoracic echocardiography. LV twist mechanics were quantitated using 2-dimensional speckle tracking imaging of the LV base and apex in short axis. Univariate associations of LV untwisting velocity (Er) were evaluated using Spearman’s correlation analysis. Significant univariate predictors (p≤0.10) were included into multivariable regression analysis to determine the independent relationship between body mass and Er (rad/s). Results: Of the first 150 children assessed (age 10.2 ± 0.3 years; 83 boys), the mean BMI was 18.2 ± 2.8 kg/m 2 . In univariate analysis, Er was inversely related to BMI (ρ= −0.13, p=0.10), LV end-diastolic diameter (ρ= −0.13, p=0.10) and LV end-systolic diameter (ρ= −0.28, p<0.001); and positively correlated with LV torsion (ρ=0.55, p<0.001), LV twisting velocity (ρ=0.29, p<0.001), early diastolic annular velocity (e′) (ρ=0.13, p=0.10), LV ejection fraction (EF) (ρ=0.14, p=0.09) and heart rate (ρ=0.18, p=0.03). There was no correlation between Er and LV relative wall thickness or mass index (p>0.25). In multivariable analysis, body mass index was independently associated with Er, independent of LV torsion, heart rate, EF, LV chamber size and e′ (Table ). Conclusion: Increased body mass is independently related to lower LV untwisting velocity during early diastole in healthy children. Additional studies are required to evaluate whether lifestyle measures to reduce body mass will attenuate further deterioration in LV diastolic relaxation and suction. Table: Independent Predictors of Left Ventricular Untwisting Velocity in Children

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Demographic, lifestyle, and reproductive determinants of serum anti-Müllerian hormone levels in adult women of reproductive age in Ilorin, North-Central Nigeria

Middle East Fertility Society Journal ◽

10.1186/s43043-021-00069-0 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Oyinkansola Islamiyat Lawal ◽

Jameelu-deen Omokunmi Yusuff

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Cycle Length ◽

Univariate Analysis ◽

Multivariable Analysis ◽

Negative Relationship ◽

Reproductive Age ◽

Enzyme Linked Immunosorbent Assay ◽

Adult Women ◽

Women Of Reproductive Age

Abstract Background Anti-Müllerian hormone is a dimeric glycoprotein produced by the granulosa cells of preantral and small antral follicles of the ovaries. It is a reliable biomarker of ovarian reserve, ageing, and response in the management of women with infertility. However, there are few studies on the determinants of serum anti-Müllerian hormone in Nigerian women. This study aimed to investigate determinants of serum anti-Müllerian hormone among adult women of reproductive age. The study was a hospital-based cross-sectional study involving 161 women of reproductive age attending the gynaecology clinic and immunisation clinic of a Nigerian tertiary hospital. Baseline characteristics were collected using a semi-structured questionnaire. Serum anti-Müllerian hormone was quantified using enzyme-linked immunosorbent assay. Results In univariate analysis, age (B = − 0.035, P = 0.000), parity (B = − 0.080, P = 0.001), and infertility duration (B = − 0.050, P = 0.011) had a negative relationship with serum anti-Müllerian hormone, while ethnicity (B = 0.180, P = 0.040), body mass index (B = 0.015, P = 0.010), and cycle length (B = 0.042, P = 0.000) had a positive relationship with serum anti-Müllerian hormone. In multivariable analysis, all relationships except infertility duration persisted. Conclusion We found that age, ethnicity, parity, infertility duration, body mass index, and cycle length were associated with serum anti-Müllerian hormone. A large prospective population-based study is required to better understand factors that are associated with serum anti-Müllerian hormone in an ethnically diverse country like Nigeria.

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Heart rate reduction improves myocardial ischemia in swine: role of interventricular blood flow redistribution

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1991.261.3.h910 ◽

1991 ◽

Vol 261 (3) ◽

pp. H910-H917 ◽

Cited By ~ 5

Author(s):

C. Indolfi ◽

B. D. Guth ◽

S. Miyazaki ◽

T. Miura ◽

R. Schulz ◽

...

Keyword(s):

Heart Rate ◽

Blood Flow ◽

Left Ventricular ◽

Regional Myocardial Blood Flow ◽

Lv Function ◽

Wall Thickening ◽

Regional Dysfunction ◽

Electrical Pacing ◽

And Function

Regional myocardial blood flow (MBF) distribution and function upon slowing the heart rate (HR) during ischemia were studied in anesthetized swine, a species without coronary collaterals. Perfusion of the left anterior descending artery by a pump allowed controlled production of regional ischemia. Slowing tachycardia by electrical pacing (127 to 87 beats/min) caused marked improvement of regional dysfunction [% wall thickening (WTh) from 9 to 27%] and increased subendocardial MBF [from 0.31 to 0.55 ml.min-1.g-1 (P less than 0.001)] without change of subepicardial MBF. Total left ventricular (LV) MBF increased, whereas right ventricular (RV) MBF fell by 18% (P less than 0.02). The mechanism of MBF changes during slowed HR was assessed by surgically excluding the RV and comparing findings with previous experiments with RV intact when HR was slowed from 96 to 60 beats/min. A similar improvement of regional LV function occurred (8% vs. 30% WTh) with the RV excluded, but without a change in total flow to the LV bed, whereas subendocardial MBF increased and subepicardial MBF fell, indicating transmural redistribution only. These findings show that the RV vascular bed can contribute to LV perfusion in swine during ischemia, and they document the potential for “reverse RV steal” during slowed heart rate in this setting.

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AB0168 BODY MASS INDEX IS ASSOCIATED WITH SIGNIFICANT ECHOCARDIOGRAPHIC ABNORMALITIES IN RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3125 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1110.2-1111

Author(s):

S. Hannawi ◽

K. Naeem ◽

H. Hannawi

Keyword(s):

Rheumatoid Arthritis ◽

Cardiovascular Disease ◽

Body Mass Index ◽

Right Ventricular ◽

Body Mass ◽

Explanatory Variable ◽

Left Ventricular ◽

The Body ◽

The Mean ◽

And Function

Background:Overweight/obesity is associated with a high incidence of chronic autoimmune diseases such as rheumatoid arthritis (RA). In RA, obesity represents an increasingly prevalent comorbidity even at its first presentation, with more than 60% of patients with RA classified as overweight or obese by the body mass index (BMI ≥25 kg/m2). On the other hand, RA is related with excess cardiovascular disease (CVD) mortality, which accounts for over 50% of premature deaths in RA. Obesity contributes to the development of inflammation via changes in metabolism and function of adipose tissue and it appears to coexist with other CVD risk factors such as hypertension, insulin resistance and dyslipidemia.Objectives:For the first time, this study looks at the effect of the BMI on echocardiography parameters in established RA cases.Methods:A cross section study was carried out to recruit patients meeting the 2010 ACR/EULAR criteria during 2019. Standard trans-thoracic echocardiography examination was performed by a specialist cardio-sonographer who was blinded to the status of the participants. The echocardiography parameters studied included left ventricular dimensions, wall geometry, systolic and diastolic parameters, ejection fraction, right ventricular size and function, valve structure and function, aortic root dimensions, pulmonary pressures and pericardium. Anthropometric measurements of BMI were carried out as weight in kilograms divided by the square of height in meters (kg/m2). Data was analysed using the BMI as the explanatory variable and repeating the simple linear regression analysis using the echocardiography parameters as outcome variables. P value of <0.05 was considered significant.Results:During the one-year period, 44 RA patients were recruited, of which 91% (40) were female and 4 (9 %) male. The mean (SD) of age was 50±13 years (Min 28, Max 72). The mean (SD) of BMI was 30.887 ± 6.348 Kg/m2 (Min 21, Max 44.38). As per BMI classification of obesity, only 11% patients were found to have normal BMI. Echocardiography revealed that 14% patients had aortic regurgitation, 2% had aortic stenosis, 2% had mitral stenosis, and 7% had tricuspid regurgitation.Using BMI as an explanatory variable, with echocardiography parameters as outcome variables, it was found that BMI contributed positively in a linear manner to the Interventricular Septal thickness in diastole (mm) (p=0.004, CI: 0.048-0.227), LV End Diastolic Diameter (mm) (p=0.033, CI: 0.033-0.722), LV mass (g) (0.04, CI: 0.022-6.339), Early Diastolic Velocity, E, by PW mitral inflow measurement (cm/s) (p=0.02, CI: 0.150-1.933), E/E’ ratio by Tissue Doppler study (p=0.01, CI: 0.025-0.225), and to Right Ventricle function measured by Tricuspid Annular Plane Systolic Excursion (TAPSE) (mm) (p=0.02, CI: 0.035-0.346).Conclusion:Obesity and Inflammation overlap syndrome may interplay to produce various cardiovascular abnormalities. Body Mass Index is shown to be associated with significant echocardiographic abnormalities including left ventricular dimension, diastolic parameters and right ventricular function. In view of the complex interrelation between obesity, rheumatoid arthritis and cardiovascular disease, measuring Body Mass Index might help predict adverse cardiovascular events in rheumatoid arthritis patients.References:[1]Body mass index and the risk of rheumatoid arthritis: a systematic review and dose-response meta-analysis. Qin B, Yang M, Fu H, Ma N, Wei T, Tang Q, Hu Z, Liang Y, Yang Z, Zhong R. Arthritis Res Ther. 2015; 17(1): 86. doi: 10.1186/s13075-015-0601-x.[2]Cardiac eccentric remodeling in patients with rheumatoid arthritis. Pascale V, Finelli R, Giannotti R, Coscioni E, Izzo R, Rozza F, Caputo D, Moscato P, Iaccarino G, Ciccarelli M. Sci Rep. 2018; 8: 5867. doi: 10.1038/s41598-018-24323-0.Disclosure of Interests:None declared

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Does obesity influence ventricular repolarisation in children?

Cardiology in the Young ◽

10.1017/s1047951120004369 ◽

2020 ◽

pp. 1-9

Author(s):

Nihan Yıldırım Yıldız ◽

Tayfun Uçar ◽

Mehmet G. Ramoğlu ◽

Merih Berberoğlu ◽

Zeynep Şıklar ◽

...

Keyword(s):

Metabolic Syndrome ◽

Body Mass Index ◽

Body Mass ◽

Wall Thickness ◽

Left Ventricular ◽

Normal Weight ◽

Qtc Interval ◽

Healthy Children ◽

Obese Children ◽

Ventricular Repolarisation

Abstract Objective: Ventricular repolarisation changes may lead to sudden cardiac death in obese individuals. We aimed to investigate the relationship between ventricular repolarisation changes, echocardiographic parameters, anthropometric measures, and metabolic syndrome laboratory parameters in obese children. Methods: The study involved 81 obese and 82 normal-weight healthy children with a mean age of 12.3 ± 2.7 years. Anthropometric measurements of participants were evaluated according to nomograms. Obese patients were subdivided into two groups; metabolic syndrome and non-metabolic syndrome obese. Fasting plasma glucose, fasting insulin, and lipid profile were measured. QT/QTc interval, QT/QTc dispersions were measured, and left ventricular systolic and diastolic measurements were performed. Results: Body weight, body mass index, relative body mass index, waist/hip circumference ratio, and systolic and diastolic blood pressures were significantly higher in obese children. QT and QTc dispersions were significantly higher in obese children and also obese children with metabolic syndrome had significantly higher QT and QTc dispersions compared to non-metabolic syndrome obese children (p < 0.001) and normal-weight healthy children (p < 0.001). Waist/hip circumference ratio, body mass index, and relative body mass index were the most important determinant of QT and QTc dispersions. Left ventricular wall thickness (left ventricular posterior wall thickness at end-diastole, left ventricular posterior wall thickness at end-systole, interventricular septal thickness at end-diastole) and left ventricular mass index were significantly higher and ejection fraction was lower in obese children. Left ventricular mass index and interventricular septal thickness at end-diastole were positively correlated with QT and QTc dispersions. Conclusions: Our study demonstrated that QT/ QTc interval prolongation and increase in QT and QTc dispersion on electrocardiogram may be found at an early age in obese children.

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Evidence of Hypertension in Healthy Children and Its Association with Body Composition and Aerobic Capacity

ACTIVE: Journal of Physical Education, Sport, Health and Recreation ◽

10.15294/active.v9i2.38474 ◽

2020 ◽

Vol 9 (2) ◽

pp. 116-121

Author(s):

Aaron Azzu Tetteh ◽

Monday Omoniyi Moses

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Heart Rate ◽

Body Composition ◽

Bone Mass ◽

Body Mass ◽

Aerobic Capacity ◽

Visceral Fat ◽

Fat Free Mass ◽

Healthy Children

Hypertension is mostly associated with adulthood and old age with little attention on children. This study provided evidence of hypertension in healthy children and its association with body composition and aerobic capacity (VO2max). 266 healthy children aged 8-11 years were recruited for the study. Blood pressure, heart rate, body mass index (BMI), basal metabolic rate (BMR), fat free mass, bone mass, visceral fat, total body water (TBW), and VO2max were measured. 18.79% were pre-hypertensive and 9.40% overweight at least, while 65.42% underweight. Correlation between blood pressure and maxVO2 was significant (P < 0.05). VO2max significantly correlate with body mass index (r = -.415, P < 0.05), fat mass (r = -.385, P < 0.05) negatively and visceral fat (r = -.267, P < 0.05) and positive with fat free mass (r =.385, P < 0.05) and bone mass (r =.077, P < 0.05). Gender differences were significant in BMR, TBW, VO2max and heart rate (P < 0.05). Evidence of hypertension in relatively healthy children is a clarion call to avert unprecedented decline in future life expectancy rate. Physical activity interventions are suggested antidotes to avert the risk factors of hypertension and excess body fat in children

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Changes in Left Ventricular Structure and Function with Increasing Body Mass Index

Heart Lung and Circulation ◽

10.1016/j.hlc.2019.06.248 ◽

2019 ◽

Vol 28 ◽

pp. S239

Author(s):

H. Chen ◽

B. Chiang ◽

A. Bhat ◽

S. Khanna ◽

T. Kayes ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Left Ventricular ◽

Structure And Function ◽

Left Ventricular Structure ◽

Ventricular Structure ◽

And Function

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Effect of body mass index on outcomes in biliary tract cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.399 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 399-399

Author(s):

Mark Doherty ◽

Mairead Geraldine McNamara ◽

Priya Aneja ◽

Lisa W Le ◽

Sean P. Cleary ◽

...

Keyword(s):

Body Mass Index ◽

Prognostic Factors ◽

Body Mass ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Univariate Analysis ◽

Multivariable Analysis ◽

Prognostic Variables ◽

Tract Cancer ◽

Definitive Surgery

399 Background: Biliary Tract Cancer (BTC) is associated with poor outcomes, and prognostic factors are not well documented. Body Mass Index (BMI) has been shown to correlate with survival in colon, breast, lung and prostate cancer. The effect of BMI on survival in patients with BTC is unclear. Greater understanding of prognostic markers in BTC can help with treatment decisions. Methods: Patients treated for BTC in Princess Margaret Cancer Centre between 06/1987 and 08/2014 were included for analysis. Data were collected on clinicopathologic features, BMI, and survival. Patients were separated into two groups by resectability: definitive surgery (DS) or no definitive surgery (NDS). Multivariable proportional hazards regression was used to investigate the association between variables and overall survival (OS) for DS and NDS groups. Results: 902 patients (461 DS, 441 NDS) were included, with median BMI 25.7 (range 15.5-48.7). Median OS was 48.1 months in DS patients and 11 months in NDS patients. 244 NDS patients received palliative chemotherapy (55%). BMI was prognostic for OS in DS patients. In univariate analysis, DS patients with BMI <25 had poorer outcomes than those with BMI ≥25 [HR 1.40, 95% CI 1.08-1.82, p=0.01]. In multivariable analysis, the effect of BMI in DS patients remained significant: BMI <25 was associated with poorer OS [HR 1.36, 95%CI 1.03-1.81, p=0.03]. No significant differences were found in OS in NDS patients according to BMI by univariate [HR 1.04, 95%CI 0.83-1.29, p=0.74] or multivariable analysis. Prognostic factors by multivariable analysis are summarized in the Table. Conclusions: For patients undergoing definitive surgery for BTC, BMI <25 was a poor prognostic marker independent of other known prognostic variables. Other prognostic variables from our dataset match reported literature. This study is limited by its retrospective nature, however BMI may aid patient risk stratification after DS for BTC. [Table: see text]

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Body Mass Index and Calprotectin Blood Level Correlation in Healthy Children: An Individual Patient Data Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9030857 ◽

2020 ◽

Vol 9 (3) ◽

pp. 857

Author(s):

Anais Grand ◽

Emmanuelle Rochette ◽

Frederic Dutheil ◽

David Gozal ◽

Valeria Calcaterra ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Inflammatory Diseases ◽

Multivariable Analysis ◽

Cochrane Library ◽

Blood Levels ◽

Low Grade ◽

Sample Type ◽

Healthy Children ◽

Z Score

Background: Calprotectin (CP) is a protein complex involved in many inflammatory diseases. Obesity is characterized by low-grade inflammation and elevated circulating levels of calprotectin. However, associations between body mass index (BMI) and calprotectin levels have not been explored in otherwise healthy children. Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed and Cochrane Library database up to July 2019. Healthy children’s blood calprotectin values were extracted, and potential correlations were explored. Results: A total of six studies that included data on 593 healthy children were identified. Median calprotectin value was 900.0 (482.0; 1700) ng·mL−1. Multivariable analysis showed no significant associations with age, sample type (serum vs. plasma), or sex. In contrast, a significant effect of BMI z-score (p < 0.001) emerged. Indeed, a positive correlation between BMI z-score and CP, was detected in girls (R: 0.48; p < 0.001) and boys (R: 0.39; p < 0.001). Conclusion: Calprotectin blood levels correlate with the degree of adiposity in healthy children, but are not affected by age, sex, or sample type (serum or plasma).

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Salusin-α levels are negatively correlated with diastolic blood pressure in children with obesity

Cardiology in the Young ◽

10.1017/s1047951119001173 ◽

2019 ◽

Vol 29 (10) ◽

pp. 1225-1229 ◽

Cited By ~ 2

Author(s):

Pınar Dervişoğlu ◽

Bahri Elmas ◽

Mustafa Kösecik ◽

Şükriye P. İşgüven ◽

Mustafa Büyükavcı ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Diastolic Blood Pressure ◽

Body Mass ◽

Negative Correlation ◽

Predictive Value ◽

Left Ventricular ◽

Control Group ◽

Healthy Children ◽

Obese Children

AbstractSalusins have emerged as a new biomarker that reflects an increased inflammatory state, which is associated with cardiovascular risk. We investigated the predictive value and usefulness of salusins as an inflammatory biomarker in obese children. This prospective cohort study included 75 obese children and 101 healthy children (as a control group). Salusin-α, Salusin-β, and various cardiovascular parameters were assessed in both groups. Correlation analyses of Salusin-α and Salusin-β with body mass index standard deviation scores and inflammatory and cardiovascular markers were performed. The mean patient age was 11.9±2.4 years for the obese group and 12.5±2.1 years for the control group. The obese children had a significantly higher heart rate, systolic blood pressure, diastolic blood pressure, epicardial adipose tissue thickness, and left ventricular mass than did the children in the control group. There was no significant correlation between Salusin-α and Salusin-β and body mass index; however, there was a negative correlation between Salusin- α and diastolic blood pressure (r = 0.277, p = 0.004). Overall, there was no significant difference in the Salusin-α and Salusin-β levels between obese and healthy children. However, a negative correlation was found between Salusin-α and diastolic blood pressure. Although this result suggests that Salusin-α might be an early marker of cardiovascular involvement in obese children, further studies are needed to demonstrate the predictive value of salusins.

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Abstract P094: Association of Body Mass Index (BMI) with Abnormalities of Cardiac Structure and Function: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽

10.1161/circ.129.suppl_1.p094 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Natalie Bello ◽

Amil M Shah ◽

Angela B Santos ◽

Gabriela Querejeta Roca ◽

Orly Vardeny ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Left Ventricular ◽

Structure And Function ◽

Overweight And Obesity ◽

Cardiac Structure ◽

Significant Difference ◽

Cardiac Structure And Function ◽

And Function ◽

Rv Function

Aim: Obesity is a prevalent condition associated with a heightened risk of cardiovascular disease. We assessed the association between normal weight, overweight, and obesity defined by body mass index (BMI) and cardiac structure and function in a sample of 4,845 older adults, aged 66-90 years. Methods: We performed a cross-sectional analysis of ARIC cohort participants during visit 5 (2011-2013), excluding those with prevalent coronary heart disease, heart failure, or prior myocardial infarction, or race other than black or white. The sample was grouped into 3 categories: normal (n=1326, BMI <25 kg/m 2 ), overweight (n=1881, BMI 25-30 kg/m 2 ), and obese (n=1638, BMI ≥30 kg/m 2 ). Cardiac structure and function were assessed by 2D echocardiography by a core lab. Non-parametric trend, χ 2 tests, linear, and logistic regression were used for this analysis. A two-sided p-value <0.05 was considered significant. Results: Participants who were obese were younger, more likely to be black, and had higher rates of diabetes and hypertension than those who were overweight or had a normal BMI (table). Participants with obesity had larger biventricular cavity sizes, higher left ventricular (LV) mass index, more diastolic dysfunction, and more abnormal geometry (concentric/eccentric hypertrophy or concentric remodeling) than those who were overweight or normal (all p <0.0001). After adjustment (table), right ventricular (RV) function was lowest in obese participants, but there was no significant difference observed in LV ejection fraction. Conclusion: In ARIC, obesity is associated with increased LV remodeling, impaired diastolic function, and decreased RV function even after adjustment for significant covariates. The relationship of these findings to subsequent clinical events and whether they can be mitigated by weight loss or maintenance warrants further study.

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