Mark A Fogel1, Thomas Pawlowski2, Marc S Keller3, Meryl S Cohen2, Elizabeth Goldmuntz2, Laura Diaz4, Christine Li2, Kevin K Whitehead5, Matthew A Harris5. 1. Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA. Electronic address: fogel@email.chop.edu. 2. Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA. 3. Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA. 4. Division of Cardiothoracic Anesthesiology, Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA. 5. Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA.
Abstract
OBJECTIVES: To determine the cardiovascular effects of obesity on patients with tetralogy of Fallot (TOF) repair. STUDY DESIGN: Ventricular performance measures were compared between obese (body mass index [BMI] ≥95%), overweight (85% ≤BMI <95%), and normal weight subjects (BMI <85%) in a retrospective review of patients with TOF who underwent cardiac magnetic resonance from 2005-2010. Significance was P < .05. RESULTS: Of 260 consecutive patients with TOF, 32 were obese (12.3%), 48 were overweight (18.5%), and 180 were normal weight (69.2%). Biventricular mass was increased in obese compared with normal weight patients with right ventricular mass more affected than left ventricular mass. Obese patients demonstrated decreased biventricular end-diastolic volume (EDV) and stroke volume (SV) when indexed to body surface area (BSA) with an increased heart rate when compared with normal weight patients; cardiac index, ejection fraction, and pulmonary regurgitation fraction were similar. When indexed to ideal BSA, biventricular EDV and SV were similar. EDV and SV for overweight patients were nearly identical to normal weight patients with ventricular mass in between the other 2 groups. CONCLUSIONS: Approximately 12% of patients after TOF repair referred for cardiac magnetic resonance in a tertiary referral center are obese with increased biventricular mass. Obese patients and normal weight patients have similar cardiac indices, however, when indexed to actual BSA, obese patients demonstrate decreased EDV and SV with increased heart rate and similar cardiac indices. When indexed to ideal BSA, no differences in biventricular volumes were noted.
OBJECTIVES: To determine the cardiovascular effects of obesity on patients with tetralogy of Fallot (TOF) repair. STUDY DESIGN: Ventricular performance measures were compared between obese (body mass index [BMI] ≥95%), overweight (85% ≤BMI <95%), and normal weight subjects (BMI <85%) in a retrospective review of patients with TOF who underwent cardiac magnetic resonance from 2005-2010. Significance was P < .05. RESULTS: Of 260 consecutive patients with TOF, 32 were obese (12.3%), 48 were overweight (18.5%), and 180 were normal weight (69.2%). Biventricular mass was increased in obese compared with normal weight patients with right ventricular mass more affected than left ventricular mass. Obesepatients demonstrated decreased biventricular end-diastolic volume (EDV) and stroke volume (SV) when indexed to body surface area (BSA) with an increased heart rate when compared with normal weight patients; cardiac index, ejection fraction, and pulmonary regurgitation fraction were similar. When indexed to ideal BSA, biventricular EDV and SV were similar. EDV and SV for overweight patients were nearly identical to normal weight patients with ventricular mass in between the other 2 groups. CONCLUSIONS: Approximately 12% of patients after TOF repair referred for cardiac magnetic resonance in a tertiary referral center are obese with increased biventricular mass. Obesepatients and normal weight patients have similar cardiac indices, however, when indexed to actual BSA, obesepatients demonstrate decreased EDV and SV with increased heart rate and similar cardiac indices. When indexed to ideal BSA, no differences in biventricular volumes were noted.
Authors: Scott A Simpson; Suzanne L Field; Meng Xu; Benjamin R Saville; David A Parra; Jonathan H Soslow Journal: Pediatr Cardiol Date: 2017-12-14 Impact factor: 1.655
Authors: Thanh T Hoang; Paulo Henrique Manso; Sharon Edman; Laura Mercer-Rosa; Laura E Mitchell; Anshuman Sewda; Michael D Swartz; Mark A Fogel; A J Agopian; Elizabeth Goldmuntz Journal: J Cardiovasc Magn Reson Date: 2019-08-19 Impact factor: 5.364