MECNUN ÇETİN, Mustafa ÇAĞLAYAN, Münevver YILDIRIMER, Baran Serdar KIZILYILDIZ, Murat DEVECİ, Şenol COŞKUN

Tissue doppler echocardiography for evaluating left ventricular functions in obese children

Amaç: Bu çalışmada obez çocuklarda transtorasik doku Doppler ekokardiyografik yöntemle sol ventrikül sistolik ve diyastolik fonksiyonlarının değerlendirilmesi amaçlandı. Gereç ve yöntem: Mitral doku Doppler sinyalleri, mitral annulus lateral duvarlarına yerleştirilen örnek hacmi ile apikal dört boşluktan kaydedildi. Pulse Doppler örneği apikal dört boşluk görüntüde mitral kapak uçlarına, akı- ma paralel olacak şekilde yerleştirilerek mitral akım tra- sesi elde edildi. Çalışmaya 20 obez (161,5±25,8 ay) ve 20 (151,2±33,5 ay) sağlıklı çocuk alınarak gerçekleştirildi. Bulgular: Vücut kitle indeksi (VKİ) obez grupta belirgin yüksekti (30,92±6,87). Sol ventrikül (LV) diyastolik fonk- siyon parametrelerinden izovolemik relaksasyon zamanı (IVRT) obez grupta 66,10±7,30 msn, kontrol grubunda ise 58,70±9,06 msn ile obez grupta anlamlı artış saptandı (p=0,007). Obez grubunda mitral anulus doku Doppler E akım hızı azalmış, A akım hızı artmış ve Em/Am oranının anlamlı derecede azalmış olduğu görüldü. VKİ ile LV Em/ Am oranı arasında anlamlı negatif ilişki saptandı. Miyo- kardiyal performans indeksi (MPİ) obez grupta 0,50±0,07, kontrol grubunda ise 0,41±0,04 (p

Obez çocuklarda sol ventrikül fonksiyonlarının değerlendirilmesinde doku doppler ekokardiyografi

Objective: The aim of this study was to investigate the impact of childhood obesity on ventricular functions using tissue Doppler echocardiography. Materials and methods: The mitral tissue Doppler signals were recorded in the apical four-chamber view, with the sample volume placed at the lateral walls of mitral annulus. The mitral flow was examined with the sample Pulse Dop- pler positioned parallely to flow just at the orifice of the mi- tral leaflets. Twenty obese (mean age, 161.5±25.8 months) and 20 healthy children (mean age, 151.2±33.5 months) were included to this study.Results: Body mass index (BMI) was significantly higher in obese group (30.92±6.87). Isovolumic relaxation time (IVRT) which is one of the left ventricular (LV) diastolic function parameters was 66.10±7.30 ms in obese group, and 58.70±9.06 ms in the control group. IVRT was sig- nificantly higher in the obese group (p=0.007). In obese group, the mitral annulus tissue Doppler E velocity was decreased, flow velocity was increased and decrement in Em/Am ratio was significant. We found significant negative correlation between BMI and LV Em/Am ratio. Myocardial performance index (MPI) in obese group and control group was 0.50±0.07 and 0.41±0.04, respectively (p<0.001). Between MPI and LV Em/Am ratio there was a significant negative correlation while MPI showed positive correlation with BMI. In obese group septal and LV posterior wall thick- ness was shown to be significantly increased compared to the control group (p<0.001). Conclusion: Our findings, may be important for determina- tion of the relationship between obesity and cardiovascular risk factors in children. Tissue Doppler echocardiographic imaging may be useful in revealing this relationship.

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