Introduction: Overweight is associated with changes in vascular and myocardial structure and function. This study compared non-invasively determined ventricular-vascular interactions in overweight adolescents with healthy controls.

Methods: Ventricular assessment included M-mode, B-mode, pulse and tissue Doppler echocardiography. Vascular assessment included carotid ultrasound, brachial artery reactivity, applanation tonometry and echo-Doppler assessment of the biophysical properties of the aorta. Ventricular-arterial coupling assessed as the ratio between arterial elastance (Ea) and end-systolic ventricular elastance (Ees), was calculated using SBP, DBP, echo-derived stroke volume and the ratio between aortic pre-ejection time and total systolic time. Between groups comparisons were performed using parametric methods with p-values>0.05 considered significant.

Results: Twenty-one overweight (BMI≥85^th percentile) adolescents (4 females; median age 14.6 years) and 27 healthy controls (4 females; median age 14.2 years) were studied. Resting heart rate, peripheral and centrally derived SBP, CIMT, aortic PWV, and radial augmentation index were higher in overweight adolescents compared with controls; carotid and aortic distensibility were lower; and flow-mediated endothelial dependent vasodilation was similar. LV mass was higher and diastolic parameters suggested abnormal relaxation in overweight adolescents. Ea was similar, but Ees and the ventricular-arterial coupling ratio Ea/Ees were both reduced in overweight adolescents.

Conclusion: Increased arterial stiffness, LV mass and abnormal ventricular relaxation in association with elevated resting heart rate and systolic blood pressure are already present in overweight adolescents. Lower end-systolic ventricular elastance may suggest an adaptive response of the ventricular-arterial coupling.