To determine whether preoperative echocardiographic parameters can predict early postoperative outcomes after arterial switch operation in late-presenting transposition of the great arteries with intact ventricular septum.

This prospective study examined preoperative demographic characteristics, echocardiographic findings, and left ventricular strain parameters in 35 patients undergoing arterial switch operation for late-presenting transposition of the great arteries with intact ventricular septum. Further, their correlation with postoperative variables, including length of ICU stay, postoperative hospital stay, extracorporeal membrane oxygenation support, and inotropic score, was assessed.

The median age at surgery was 45 days, and the median weight was 3.4 kg. The median interventricular septal thickness was 4.1 mm, and the median left ventricular mass index was 26.4 g/m2. The median average left ventricular strain was −24.19. Thirteen patients required extracorporeal membrane oxygenation support. The whole cohort had a median extracorporeal membrane oxygenation duration of 0 days. The median length of ICU stay was 12 days, and the median length of postoperative hospital stay was 17 days. The median inotropic score was 28. There was no case of early mortality. None of the preoperative echocardiographic parameters showed a statistically significant association with postoperative outcomes.

Preoperative echocardiographic parameters, including left ventricular strain, did not significantly predict early postoperative outcomes after arterial switch operation in patients with late-presenting transposition of the great arteries with intact ventricular septum. Postoperative outcomes in this patient group are likely influenced by multiple preoperative factors rather than a single preoperative echocardiographic parameter.

Obesity is an independent risk factor for cardiovascular diseases. The study aims to assess the left ventricular structure and functions in children with obesity.

This study included 29 patients with metabolic syndrome, 31 patients with obesity without metabolic syndrome, and 30 healthy children of similar age and gender. Demographic, anthropometric, and biochemical findings and left ventricular structure and functions evaluated by conventional pulsed wave Doppler and tissue Doppler echocardiography were compared.

The left ventricular mass index and relative wall thickness were significantly higher in children with obesity compared to controls. The mean left ventricular mass index of children with metabolic syndrome was also higher than for those without it. Most children with obesity had normal left ventricular geometry; concentric hypertrophy (27.6%) was more common in children with metabolic syndrome, and eccentric hypertrophy (25.7%) was more common in those without. The early to late diastolic mitral annular velocity ratios obtained with conventional pulsed wave Doppler echocardiography and tissue Doppler echocardiography (E/A and Em/Am, respectively) were lower in children with obesity than controls. In addition, the ratio obtained by tissue Doppler echocardiography was lower in children with metabolic syndrome than without. The homeostatic model assessment of insulin resistance, systolic blood pressure, and body mass index has been identified as independent factors for left ventricular structures and functions.

Obesity causes subclinical left ventricular hypertrophy and diastolic dysfunction. Additional metabolic syndrome-related risks lead to further deterioration of cardiac morphology and functions.

The relationship between different surrogates of insulin resistance and left ventricular geometry in obese children is still unclear.

We sought to explore the relationship between commonly used measures of insulin sensitivity/resistance (homeostatic model assessment index, serum uric acid, and triglycerides to high-density lipoprotein cholesterol ratio) and left ventricular geometry in normotensive obese children.

In this cross-sectional study, 32 normotensive obese children were examined. Transthoracic echocardiography was used to measure left ventricular mass index and relative wall thickness. Homeostasis model assessment index, serum uric acid level, and a ratio of triglycerides to high-density lipoprotein cholesterol were used as markers of the insulin resistance. Simple and partial correlation analyses (to control for the effects of body mass index) were conducted to explore relationship between studied variables and left ventricular mass index or relative wall thickness as outcome variables.

We found positive correlations between homeostasis model assessment index and relative wall thickness (r = 0.47, p = 0.03) which remained significant after controlling for the effect of body mass index, z-score (r = 0.48, p = 0.03). The cutoff level of homeostasis model assessment index with the optimum sensitivity (Sn) and specificity (Sp) derived from the receiver operating characteristic (ROC) curves for predicting concentric remodelling was ≥5.51 with Sn = 83.33 and Sp = 68.75.

There is a positive relationship between homeostasis model assessment index and relative wall thickness of obese normotensive children which may help to distinguish at risk obese normotensive children for the development of concentric left ventricular remodelling.

In our previous study, the prevalence of childhood masked hypertension was 11%. This study aims to assess the left ventricular mass index of persistent masked hypertension and determine the factors of elevated left ventricular mass index in Hong Kong Chinese adolescents from a community cohort.

Community prospective cohort study, follow-up of a case-control study in community.

Patients with masked hypertension at baseline were invited to recheck ambulatory blood pressure for the persistence of masked hypertension.

A total of 144 out of 165 patients with masked hypertension in the 2011/2012 ambulatory blood pressure survey consented to participate in the study. In all, 48 patients were found to have persistent masked hypertension by ambulatory blood pressure rechecking and were matched with normotensive controls by sex, age, and body height. The left ventricular mass (117.3±39.9 g versus 87.0±28.2 g versus 102.0±28.2 g) and left ventricular mass index (30.1±8.4 g/m2.7 versus 23.9±6.3 g/m2.7 versus 25.1±5.7 g/m2.7) were significantly higher in the persistent masked hypertension group (p<0.0001) compared with the patients without persistent masked hypertension and controls. In multivariate linear regression analysis, left ventricular mass index was found to be higher in male gender (β=4.874, p<0.0001) and the patients with persistent masked hypertension (β=2.796, p=0.003). In addition, left ventricular mass index was positively associated with body mass index z-score (β=3.045, p<0.0001) and low-density lipoprotein cholesterol concentration (β=1.634, p=0.015).

Persistent masked hypertension in adolescents is associated with elevated left ventricular mass index.