Introduction: Elevated left ventricular (LV) mass and abnormal LV mechanics have been associated with adverse cardiovascular events in adults and differ by race and body mass index (BMI). Cardiovascular risk factors (CVRFs) leading to adverse events in adults, such as obesity and hypertension (HTN), are increasingly prevalent in pediatric patients yet limited data on echocardiographic (echo) changes in children exist. Patients referred to the HTN program at our institution routinely undergo echos. We hypothesized that children with CVRFs would have abnormalities in LV measurements and that these values differ by race and BMI.
Methods: Data was collected from all first patient visits to the HTN and Vascular Evaluation Program from 12/2011 to 12/2015. Left ventricle septal and posterior wall thickness (PWT) with z-scores by m-mode, LV mass index (LVMI) with percentiles and LV strain were collected. LV hypertrophy was defined as an LV septal or PWT z-score >2. These LV measurements were compared between race, BMI and blood pressure using chi-square analysis or Student’s t-test.
Results: There were 242 patients evaluated, with an average age of 14.5±4.2 years. There were no differences in LV measurements between patients with and without HTN. LV hypertrophy was not common. Average LVMI, LVMI >95%ile and LV strain were significantly different in our obese patients and LVMI>95%ile was more likely in African American patients (table 1).
Conclusions: While most patients did not have LV hypertrophy, LVMI was significantly higher and LV strain, significantly lower in obese patients. African American patients were more likely to have an LVMI>95%ile. Lack of differences in LV measurements between those patients with and without HTN may be due to the small number of normotensive patients. Further study into echo findings in pediatric patients with CVRFs could allow for early recognition of subclinical changes and for tailored management to preserve long-term CV health.