Benefits in Cardiac Function from a Remote Exercise Program in Children with Obesity

Author:

Mannarino Savina1,Santacesaria Sara1,Raso Irene1,Garbin Massimo1ORCID,Pipolo Andreana1,Ghiglia Silvia1,Tarallo Gabriele1,De Silvestri Annalisa2ORCID,Vandoni Matteo3ORCID,Lucini Daniela45ORCID,Carnevale Pellino Vittoria36ORCID,Bernardelli Giuseppina57,Gatti Alessandro3ORCID,Rossi Virginia8ORCID,Calcaterra Valeria89ORCID,Zuccotti Gianvincenzo810ORCID

Affiliation:

1. Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy

2. Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy

3. Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy

4. BIOMETRA Department, University of Milan, 20129 Milan, Italy

5. Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy

6. Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy

7. DISCCO Department, University of Milan, 20122 Milan, Italy

8. Pediatric Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy

9. Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy

10. Department of Biomedical and Clinical Science, University of Milano, 20157 Milan, Italy

Abstract

Physical activity (PA) is a crucial factor in preventing and treating obesity and related complications. In this one-arm pre–post longitudinal prospective study, we evaluated the effects of a 12-week online supervised training program on cardiac morphology, function and blood pressure (BP) in children with obesity. The training program consisted of three sessions per week, each lasting 60 min. Advanced echocardiographic imaging (tissue Doppler and longitudinal strain analysis) was used to detect subclinical changes in heart function. Categorical variables were described as counts and percentages; quantitative variables as the mean and standard deviation (SD) as they were normally distributed (Shapiro–Wilks test). Pre–post comparisons were made with a paired t-test. A total of 27/38 (71%) enrolled patients (18M/9F, 11 ± 2 years) completed the training protocol and were considered in the analysis. At baseline, no hypertensive patient was noted; all echocardiographic variables were within the normal range. After training, we observed a significant reduction in BP parameters, including systolic BP values and Z-score, diastolic BP values, centiles and Z-score, and mean arterial pressure (all p < 0.05). Significant variations in echocardiographic interventricular septum (IVSd) thickness (p = 0.011), IVSd Z-score (p = 0.001), left ventricular (LV) end-diastolic diameter (p = 0.045), LV posterior wall thickness Z-score (p = 0.017), and LV global longitudinal strain (p = 0.016) were detected. No differences in LV diastolic function and right ventricular strain were noted. PA plays a decisive role in improving BP control and has benefits on left ventricle systolic function, representing a strategic approach to limit CV risk. Online exercise could be an excellent method of training in children with obesity.

Funder

Italian Ministry of Health

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

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