Chronotropic Incompetence During Exercise in Obese Adolescents: Clinical Implications and Pathophysiology
- Conditions
- ObesityAdolescent Obesity
- Interventions
- Other: the prevalence of chronotropic incompetence CI during maximal cardiopulmonary exercise testing, CPET
- Registration Number
- NCT03516721
- Lead Sponsor
- Hasselt University
- Brief Summary
A reduction in peak heart rate (HR) and suppressed HR response during exercise is highly prevalent in obese populations. This phenomenon is also known as chronotropic incompetence (CI). In adult obese individuals, CI is independently related to elevated risk for major adverse cardiovascular events and premature death. Despite the established association between CI and prognosis in adult populations, the prognostic relevance of CI in adolescents with obesity has however deserved no attention, but is important. CI during exercise testing may indicate various, yet undetected anomalies, such as altered blood catecholamine and/or potassium concentrations during exercise, structural myocardial abnormalities or ventricular stiffness, impaired baroreflex sensitivity and cardiovascular autonomic dysfunction, atherosclerosis, or cardiac electrophysiological anomalies, which all have been detected in obese children and adolescents. However, whether CI during exercise testing may be a sensitive and specific indicator for these anomalies in obese adolescents has not been studied yet. In addition, the exact physiology behind obesity and development of heart disease remains to be studied in greater detail in obese adolescents. In this project, we examine the prevalence of CI (during maximal cardiopulmonary exercise testing, CPET) in 60 obese adolescents (aged 12-16 years) vs. 60 lean adolescents, and study the association between CI and changes in CPET parameters, lactate, catecholamine and potassium concentrations during CPET, biochemical variables, and cardiac electrophysiology (by ECG recording). In addition, the relation between CI and cardiac function (echocardiography) will be examined in a subgroup (29 lean and 29 obese) of these adolescents. In this regard, the diagnostic value of HR (responses) during maximal exercise testing will be clarified in obese adolescents, and the physiology behind the elevated risk for heart disease in obese adolescents can be explored.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 120
- aged 12-16 years
- obese or lean (based on extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity)
- Parental permission
- Chronic cardiovascular, renal, pulmonary and orthopedic disease
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Obese adolescents the prevalence of chronotropic incompetence CI during maximal cardiopulmonary exercise testing, CPET - Lean adolescents the prevalence of chronotropic incompetence CI during maximal cardiopulmonary exercise testing, CPET -
- Primary Outcome Measures
Name Time Method Ventilatory function day 1 Determined during maximal cardiopulmonary exercise testing.
Heart rate (HR) day 1 Assessed using a 12-lead ECG device
- Secondary Outcome Measures
Name Time Method cortisol and serum insulin day 1 blood analyses
PAQ-A (Physical Activity Questionaire for Adolescents) day1 physical activity determined using the validated Dutch physical activity questionnaire for adolescents
high-density lipoprotein cholesterol day 1 blood analyses
c-reactive proteine day 1 blood analyses
free thyroxine day 1 blood analyses
iron day 1 blood analyses
uric acid day 1 blood analyses
body composition day 1 aspartate aminotransferase day 1 blood analyses
alkaline phosphatase day 1 blood analyses
low-density lipoprotein cholesterol day 1 blood analyses
proteins day 1 blood analyses
weight day 1 Plasma glucose day 1 blood analyses
alanine aminotransferase day 1 blood analyses
gamma-glutamyl transpeptidase day 1 blood analyses
thyroid-stimulating hormone day 1 blood analyses
leukocytes day 1 blood analyses
Echocardiography day 1 Assessment left ventricular structure and systolic and diastolic function
height day 1 Tanner scale day 1 Puberty stage (ranging from 1 to 5) will be assessed in all participants by the pediatric endocrinologist using Tanner staging criteria.
Boys - development of external genitalia Girls - breast development Boys and girls - pubic haircalcium day 1 blood analyses
blood total cholesterol day 1 blood analyses
triglyceride concentrations day 1 blood analyses
serum leptin concentration day 1 blood analyses
haematocrit day 1 blood analyses
blood haemoglobin day 1 blood analyses
Trial Locations
- Locations (1)
Jessa Ziekenhuis
🇧🇪Hasselt, Belgium