Impact of Diet and Exercise Training-Induced Weight Loss on Myocardial Mechanics in Severely Obese Adolescents

Authors

  • Philippe Obert,

    Corresponding author
    1. EA 4278, Laboratoire de Pharm-Ecologie Cardiovasculaire, University of Avignon, Avignon, France
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  • Carine Gueugnon,

    1. EA 3920, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires; IFR133, Faculty of Medicine, University of Franche Comté, Besançon, France
    2. Faculty of Sports Sciences, University of Franche Comté, Besançon, France
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  • Stéphane Nottin,

    1. EA 4278, Laboratoire de Pharm-Ecologie Cardiovasculaire, University of Avignon, Avignon, France
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  • Agnes Vinet,

    1. EA 4278, Laboratoire de Pharm-Ecologie Cardiovasculaire, University of Avignon, Avignon, France
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  • Sandrine Gayrard,

    1. EA 4278, Laboratoire de Pharm-Ecologie Cardiovasculaire, University of Avignon, Avignon, France
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  • Thomas Rupp,

    1. EA 4278, Laboratoire de Pharm-Ecologie Cardiovasculaire, University of Avignon, Avignon, France
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  • Gilles Dumoulin,

    1. EA 3920, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires; IFR133, Faculty of Medicine, University of Franche Comté, Besançon, France
    2. Explorations fonctionnelles-Physiologie, Laboratoire de Biochimie Endocrinienne et Métabolique, Minjoz University Hospital, Besançon, France
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  • Nicolas Tordi,

    1. EA 3920, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires; IFR133, Faculty of Medicine, University of Franche Comté, Besançon, France
    2. Faculty of Sports Sciences, University of Franche Comté, Besançon, France
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  • Fabienne Mougin

    1. EA 3920, Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires; IFR133, Faculty of Medicine, University of Franche Comté, Besançon, France
    2. Faculty of Sports Sciences, University of Franche Comté, Besançon, France
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  • Disclosure: The authors have no competing interests.

Abstract

Objective

Recent findings indicated silent incipient myocardial dysfunction in juvenile obesity despite normal global cardiac function. The present study investigated whether lifestyle intervention is able to favorably impact these obesity-related myocardial abnormalities and whether improvements are related to changes in insulin resistance and cardiac remodeling.

Design and Methods

Twenty-eight severe obese adolescents (OB) participated in a 9 month lifestyle intervention program (LIP) based on aerobic exercise and diet. Twenty healthy adolescents (CG) served as controls. Conventional echocardiography and myocardial mechanics were obtained at baseline and follow-up along with insulin resistance.

Results

Insulin sensitivity improved (P < 0.001) and body weight decreased (P < 0.001) consecutive to LIP. At baseline, OB had depressed longitudinal (L) strain (CG: −18.3 ± 2.6, OB: −14.2 ± 3.6%, P < 0.001) and enhanced twist compared to controls. The LIP in OB restored L strain to normal values (−16.9 ± 3.5%, NS), whereas it did not affect twist mechanics. From stepwise multiple regression analysis, only baseline L strain and changes in BMI Z-score (r2-adjusted = 0.49, P < 0.001) emerged as independent predictors of L strain changes.

Conclusions

Juvenile obesity is associated with myocardial mechanic abnormalities that can be partly corrected by lifestyle intervention. Restoration of longitudinal myocardial function occurs in the absence of left ventricular remodeling changes and is not associated with insulin resistance improvements.

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