Left atrial remodeling in adolescents with obesity evaluated by speckle-tracking echocardiography

Background and aims: In adolescents with obesity, a left atrial (LA) enlargement has been reported. However, data regarding its function and its stiffness are missing. The aim of this study was to describe LA morphology and function, using speckle-tracking echocardiography (STE) and to explore their potential determinants in adolescents with obesity.Methods: Twenty-eight adolescent women with obesity (13.2 +/- 1.4 yr) with an illness duration of 130 +/- 27 months and 33 controls (14.1 +/- 2.0 yr) underwent a resting echocardiography including an analysis of left ventricular (LV) and LA morphologies and strains. A fasting venous blood sample was performed to biochemical determinations including inflammation markers.Results: LA volume and stiffness index were increased in adolescents with obesity compared to controls. LA reservoir, conduit and booster pump functions were not different between groups. By stepwise forward multivariate regression analyses, systolic blood pressures, cardiac output and sedimentation rate were the independent determinants of LA volume (p < 0.0001, beta-coefficient = 0.460) whereas only the body mass index was an independent determinant of LA stiffness (p = 0.003, beta-coefficient = 0.413).Conclusion: In adolescents with obesity, we observed a specific LA remodeling, including higher volume and lower stiffness, which could constitute early signs of an altered LV diastolic function.