The impact of obesity on left ventricular hypertrophy and diastolic dysfunction in children and adolescents

Joanna Bartkowiak, Ernest Spitzer, Reto Kurmann, Fabian Zürcher, Peter Krähenmann, Victoria Garcia-Ruiz, Jorge Mercado, Christoph Ryffel, Sylvain Losdat, Nassip Llerena, Pedro Torres, Jonas Lanz, M Stocker, Ben Ren, Martin Glöckler, Thomas Pilgrim*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)


Childhood obesity continues to escalate worldwide and may affect left ventricular (LV) geometry and function. The aim of this study was to investigate the impact of obesity on prevalence of left ventricular hypertrophy (LVH) and diastolic dysfunction in children. In this analysis of prospectively collected cross-sectional data of children between 5 and 16 years of age from randomly selected schools in Peru, parameters of LV geometry and function were compared according to presence or absence of obesity (body mass index z-score > 2). LVH was based on left ventricular mass index (LVMI) adjusted for age and sex and defined by a z-score of > 2. LV diastolic function was assessed using mitral inflow early-to-late diastolic flow (E/A) ratio, peak early diastolic tissue velocities of the lateral mitral annulus (E′), early diastolic transmitral flow velocity to tissue Doppler mitral annular early diastolic velocity (E/E′) ratio, and left atrial volume index (LAVI). Among 1023 children, 681 children (mean age 12.2 ± 3.1 years, 341 male (50.1%)) were available for the present analysis, of which 150 (22.0%) were obese. LVH was found in 21 (14.0%) obese and in 19 (3.6%) non-obese children (padjusted < 0.001). LVMI was greater in obese than that in non-obese children (36.1 ± 8.6 versus 28.7 ± 6.9 g/m2.7, p < 0.001). The mean mitral E/E′ ratio and LAVI were significantly higher in obese than those in non-obese individuals (E/E′: 5.2 ± 1.1 versus 4.9 ± 0.8, padjusted = 0.043; LAVI 11.0 ± 3.2 versus 9.6 ± 2.9, padjusted = 0.001), whereas E′ and E/A ratio were comparable. Childhood obesity was associated with left ventricular hypertrophy and determinants of diastolic dysfunction. Identifier: NCT02353663.

Original languageEnglish
Article number13022
JournalScientific Reports
Issue number1
Publication statusPublished - 22 Jun 2021

Bibliographical note

Funding Information:
The study was supported by a dedicated research grant from the Bangerter-Rhyner foundation, Switzerland.

Publisher Copyright:
© 2021, The Author(s).


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