Two-Dimensional Strain and Twist by Vector Velocity Imaging in Adolescents With Severe Obesity

Authors

  • Philippe Obert,

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

    1. EA 3920, «Physiopathologie Cardio-Vasculaire et Prévention», 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”, Faculty of Sciences, University of Avignon, Avignon, France
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  • Agnes Vinet,

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

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

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

    1. EA 3920, «Physiopathologie Cardio-Vasculaire et Prévention», 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, «Physiopathologie Cardio-Vasculaire et Prévention», 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, «Physiopathologie Cardio-Vasculaire et Prévention», 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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(philippe.obert@univ-avignon.fr)

Abstract

The prevalence of severe obesity is increasing worldwide in adolescents. Whether it is associated with functional myocardial abnormalities remains largely unknown, potentially because of its frequent association with other cardiovascular risk factors and also use of insensitive techniques to detect subclinical changes in myocardial function. We used 2D vector velocity imaging (VVI) to investigate early changes in left ventricular (LV) myocardial function in youths with isolated severe obesity. Thirty-seven asymptomatic severely obese adolescents free of diabetes and hypertension, and 24 lean controls were enrolled. LV longitudinal, basal, and apical circumferential strain, strain rate (SR), rotations, and LV twist were measured. Obese adolescents had greater LV mass and reduced systolic and early diastolic tissue Doppler imaging (TDI) velocities than lean counterparts. L strain (−24%) and systolic and early diastolic SR were also diminished in the obese, whereas no intergroup differences existed for the circumferential deformation indexes. LV twist was more pronounced in the obese (+1.7°, P < 0.01) on account of greater apical rotation only (4.1 ± 0.9 vs. 5.2 ± 1.2°, P < 0.01), potentially compensating for the loss in longitudinal function. Systolic—diastolic coupling, an important component of early filling and diastolic function, was maintained with severe obesity. No intergroup differences were reported regarding time to peak values for all VVI indexes highlighting that dynamics of strain and twist/untwist along the cardiac cycle was preserved with severe obesity. Isolated severe obesity in adolescents, at a preclinical stage, is associated with changes in myocardial deformation and torsional mechanics that could be in part related to alterations in relaxation and contractility properties of subendocardial fibers.

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