J Cardiovasc Ultrasound.  2015 Mar;23(1):10-19. 10.4250/jcu.2015.23.1.10.

Cardiovascular Screening in Asymptomatic Adolescents with Metabolic Syndrome

• Bae HK
• Choi HS
• Sohn S
• Shin HJ
• Nam JH
• Hong YM

• KMID: 2135401
• DOI: http://doi.org/10.4250/jcu.2015.23.1.10

Abstract

BACKGROUND
In recent days, the prevalence of childhood metabolic syndrome (MS) has increased substantially due to the increasing rate of childhood obesity on a global scale. The aims of this study were to detect the important parameters and provide the screening system to prevent cardiovascular disease in adolescents with MS.
METHODS
Ninety one male adolescents were divided into two groups based on the presence or absence of MS. Anthropometric measurement and laboratory study were studied. Intimal medial thickness and pulse wave velocity were estimated. Left ventricular mass index (LVMI), ejection fraction, myocardial velocity, strain and strain rate were measured by tissue Doppler imaging and strain rate imaging.
RESULTS
The prevalence of MS was 7.7%. Weight, body mass index (BMI), waist circumference (WC), glucose, insulin, homeostasis model assessment of insulin resistance, triglyceride and LVMI were significantly increased in the MS group. High density lipoprotein-cholesterol (HDL-C), peak early diastolic myocardial velocity (e'), systolic myocardial velocity (s') and global longitudinal strain were significantly lower in the MS group. In univariant analysis, LVMI was significantly correlated with BMI, WC, fat %, fat mass, systolic blood pressure, alanine aminotransferase, total cholesterol (TC) and low density lipoprotein-cholesterol. e' was significantly correlated with BMI, fat %, fat mass, and HDL-C. Global circumferential strain had significant correlation with glucose and TC. Basal anterolateral strain rate was significantly correlated with weight, BMI, WC, fat %, and fat mass.
CONCLUSION
LVMI, strain and strain rate are practical and accurate parameters for assessment of left ventricular function in adolescents with MS.

Keyword

Metabolic syndrome; Adolescent; Tissue Doppler imaging; Strain rate

MeSH Terms

Adolescent*
Alanine Transaminase
Blood Pressure
Body Weight
Cardiovascular Diseases
Cholesterol
Glucose
Homeostasis
Humans
Insulin
Insulin Resistance
Mass Screening*
Pediatric Obesity
Prevalence
Pulse Wave Analysis
Triglycerides
Ventricular Function, Left
Waist Circumference
Alanine Transaminase
Cholesterol
Glucose
Insulin

Figure

• 

  Fig. 1 Mitral flow by conventional pulse Doppler imaging and tissue Doppler imaging. A: Early diastolic (E), late atrial (A) peak velocities in mitral inflow by conventional pulse Doppler imaging. B: Systolic myocardial velocity (s'), peak early diastolic myocardial velocity (e'), peak late diastolic myocardial velocity (a') by tissue Doppler imaging.

• 

  Fig. 2 Two-dimensional (2D) strain and strain rate by strain rate imaging. 2D strain imaging showing left ventricular longitudinal strain (A) and strain rate imaging (B). BIS: basal interventricular septum, BAL: basal anterolateral, MIS: medium interventricular septum, MAL: medium anterolateral, ApS: apical septum, ApL: apical lateral septum.

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