Does obesity have an effect on the ECG in children?
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Alexandra Kiess
Abstract
This review summarizes current data on influences of childhood obesity on the 12-lead electrocardiogram (ECG). Studies on obese adults showed a higher risk of cardiovascular complications and also, partly pathological, ECG alterations. Data on ECG alterations in obese children is rare. In current studies, no pathological findings were found. All alterations, which mimic the later pathological phenomena in obese adults, were within normal ranges. Studies reported significantly longer P-wave time and P-wave dispersion (Pd) in obese children [Üner A, Doğan M, Epcacan Z, Epçaçan S. The effect of childhood obesity on cardiac functions. J Pediatr Endocr Met 2014;27:261–71.], no correlation of heart rate, P-wave, or QT dispersions (QTd) [Akyüz A, Alpsoy S, Akkoyun DC, Nalbantoǧlu B, Tülübaș F, et al. Effect of overweight on P-wave and QT dispersions in childhood. Turk Kardiyol Dern Ars 2013;41:515–21.], significantly higher QTd in obese children [Yildirim S, Binnetoglu FK, Battal F, Aylanc H, Nazan Kaymaz N, et al. Relation between QT variables and left ventricular geometry in athletes and obese children. Acta Med Port 2016;29:95–100.], no significant association between obesity and QTc interval (QTc), but longer PR intervals, wider QRS duration and left axis shifting of frontal P-wave, QRS and T-wave axes [Sun G, Li Y, Zho X, Guuo X, Zhang X, et al. Association between obesity and ECG variables in children and adolescents: a cross-sectional study. Exp Ther Med 2013;6:1455–62.], significant prolongation of QTc, T peak-to-end, and QTd in the obese children [Paech C, Liebold A, Gebauer RA, Wagner F, Vogel M, et al. Relative QT interval prolongation and electrical inhomogeneity of cardiac repolarization in childhood obesity. Prog Pediatr Cardiol 2017;47:64–7.], slight shift to the left in the QRS axis (with no changes in the P axis), increased amplitudes of the left-sided leads in obese children, and no correlation of the heart rate with the weight [Paech C, Anhalt M, Gebauer RA, Wagner F, Vogel M, et al. New normal limits for pediatric ECG in childhood obesity? Influence of childhood obesity on the ECG. Prog Pediatr Cardiol 2018;48:119–23.]. Altogether, the study results are inconsistent. Clearly, pathological phenomena in the ECG of obese children were not reported: only preliminary stages like QTc prolongation within the norm were found. The pathological alterations seen in adult obese patients are not (yet) seen in childhood. The slight changes reported in childhood obesity are likely to manifest later and to develop into pathological phenomena in obese adults and, therefore, might increase the risk of cardiovascular events like arrhythmia and sudden cardiac death in adulthood.
Acknowledgments
We thank the “LIFE Child Study” team as well as all children and parents for their participation and assistance. The “LIFE Child Study’” is financed by means of the Free State of Saxony, Germany.
Author statements: The manuscript submitted is original, with no portion under simultaneous consideration for publication elsewhere or previously published. Only those who have made an important contribution to the study and are thoroughly familiar with the primary data are included as authors. All authors are responsible for the contents and have acknowledged the manuscript.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Artikel in diesem Heft
- Frontmatter
- Reviews
- Occurrence and clinical management of nonalcoholic fatty liver disease in obesity patients: a literature review
- Does obesity have an effect on the ECG in children?
- Original Articles
- Factors associated with oxidative stress status in pediatric patients with type 1 diabetes mellitus
- The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes
- Psychiatric view for disorders of sex development: a 12-year experience of a multidisciplinary team in a university hospital
- Effect of high-dose vitamin D supplementation on antibody titers to heat shock protein 27 in adolescent girls
- Effects of whole-body vibration training on bone density and turnover markers in adolescent swimmers
- Estimations of total serum testosterone levels in Nigerian term neonates at birth using anogenital distance measurements
- Inborn errors of metabolism detectable by tandem mass spectrometry in Beijing
- Identification of two novel variants in GNPTAB underlying mucolipidosis II in a Pakistani family
- Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study
- Case Reports
- First Scandinavian case of successful pregnancy during nitisinone treatment for type 1 tyrosinemia
- A novel etiologic factor of highly elevated cholestanol levels: progressive familial intrahepatic cholestasis
- Congenital hyperinsulinism due to compound heterozygous mutations in ABCC8 responsive to diazoxide therapy
- Hyperinsulinism hyperammonaemia (HI/HA) syndrome due to GLUD1 mutation: phenotypic variations ranging from late presentation to spontaneous resolution
- Corrigendum
- Corrigendum to: The effects of a 12-week jump rope exercise program on body composition, insulin sensitivity, and academic self-efficacy in obese adolescent girls
