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Revista chilena de cardiología

versão On-line ISSN 0718-8560


GABRIELLI, Luigi et al. Speckle tracking derived left atrial strain and strain rate are related to high sensitive C reactive protein in obese adolescents. Rev Chil Cardiol [online]. 2011, vol.30, n.2, pp.95-102. ISSN 0718-8560.

Background: Obesity is an emerging problem in children worldwide and a well-known risk factor for atrial fibrillation (AF) in adulthood. There is some evidence that functional and structural changes responsible for the development of AF may arise early in life. Left atrial (LA) strain and strain rate, assessed by speckle tracking, are indices of LA function and correlate with the development of AF. Objective: To evaluate LA strain and strain rate in obese adolescents and their correlation with plasma levels of high sensitive C reactive protein (hs-CRP) and adiponec-tin, two markers of cardiovascular risk. Methods: Fifteen obese adolescents, age 13 ± 0.2 yr, body mass index (BMI)-z-score 1.9 ± 0.16 and 15 lean controls were recruited. All patients underwent transtho-racic echocardiography with evaluation of LA strain and strain rate: a wave (LASa and LASRa) and s wave (LASs and LASRs). Plasma levels of hs-CRP was determined. Student's t test, chi-square and Pearson correlation were used for statistical analysis. Results: Obese patients had a lower LASs (44 ± 1.8 vs 32 ± 1.1%, p < 0.01), LASa (- 1.7 ± 0.3 vs - 0.7 ± 0.1, p < 0.01), LASRs (1.7 ± 0.07 vs 1.3 ± 0.03, p < 0.01) and LASRa (- 1.8 ± 0.1 vs - 1.2 ± 0.08, p < 0.01). Plasma hs-CRP levels were significantly higher in the obese group and displayed a significant inverse correlation with LASs (r: - 0.62, p < 0.01) and LASRs (r: - 0.58, p = 0.02). Conclusion: Obese adolescents had an impaired LA function compared to age-matched lean subjects, which correlated with an increased inflammatory state. It is likely that LA dysfunction may predispose to AF later in life.

Palavras-chave : Obesity; childhood; left atrium; speckle tracking; strain; strain rate; atrial fibrillation.

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