{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:39:02Z","timestamp":1790278742071,"version":"4.1.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,8,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Childhood obesity is a significant risk factor for cardiovascular disease in adulthood. Although ventricular remodeling has been reported in obese youth, early tissue\u2010level markers within the myocardium that precede organ\u2010level alterations have not been described.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We studied 21 obese adolescents (mean age, 17.7\u00b12.6\u00a0years; mean body mass index [\n              <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n              ], 41.9\u00b19.5\u00a0kg\/m\n              <jats:sup>2<\/jats:sup>\n              , including 11 patients with type 2 diabetes [T2D]) and 12 healthy volunteers (age, 15.1\u00b14.5\u00a0years;\n              <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n              , 20.1\u00b13.5\u00a0kg\/m\n              <jats:sup>2<\/jats:sup>\n              ) using biomarkers of cardiometabolic risk and cardiac magnetic resonance imaging (\n              <jats:styled-content style=\"fixed-case\">CMR<\/jats:styled-content>\n              ) to phenotype cardiac structure, function, and interstitial matrix remodeling by standard techniques. Although left ventricular ejection fraction and left atrial volumes were similar in healthy volunteers and obese patients (and within normal body size\u2010adjusted limits), interstitial matrix expansion by\n              <jats:styled-content style=\"fixed-case\">CMR<\/jats:styled-content>\n              extracellular volume fraction (\n              <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content>\n              ) was significantly different between healthy volunteers (median, 0.264; interquartile range [IQR], 0.253 to 0.271), obese adolescents without T2D (median, 0.328; IQR, 0.278 to 0.345), and obese adolescents with T2D (median, 0.376; IQR, 0.336 to 0.407;\n              <jats:italic>P<\/jats:italic>\n              =0.0001).\n              <jats:styled-content style=\"fixed-case\">ECV<\/jats:styled-content>\n              was associated with\n              <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>\n              for the entire population (\n              <jats:italic>r<\/jats:italic>\n              =0.58,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and with high\u2010sensitivity C\u2010reactive protein (\n              <jats:italic>r<\/jats:italic>\n              =0.47,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05), serum triglycerides (\n              <jats:italic>r<\/jats:italic>\n              =0.51,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05), and hemoglobin A1c (\n              <jats:italic>r<\/jats:italic>\n              =0.76,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001) in the obese stratum.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Obese adolescents (particularly those with T2D) have subclinical alterations in myocardial tissue architecture associated with inflammation and insulin resistance. These alterations precede significant left ventricular hypertrophy or decreased cardiac function.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000279","type":"journal-article","created":{"date-parts":[[2013,8,21]],"date-time":"2013-08-21T02:34:33Z","timestamp":1377052473000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Myocardial Tissue Remodeling in Adolescent Obesity"],"prefix":"10.1161","volume":"2","author":[{"given":"Ravi V.","family":"Shah","sequence":"first","affiliation":[{"name":"Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"},{"name":"Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddique A.","family":"Abbasi","sequence":"additional","affiliation":[{"name":"Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas G.","family":"Neilan","sequence":"additional","affiliation":[{"name":"Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"},{"name":"Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Hulten","sequence":"additional","affiliation":[{"name":"Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otavio","family":"Coelho\u2010Filho","sequence":"additional","affiliation":[{"name":"Cardiology Division, State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Hoppin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, MassGeneral Hospital for Children, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Levitsky","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, MassGeneral Hospital for Children, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"de Ferranti","sequence":"additional","affiliation":[{"name":"Preventative Cardiology, Boston Children's Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erinn T.","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Boston Children's Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avram","family":"Traum","sequence":"additional","affiliation":[{"name":"Division of Nephrology, MassGeneral Hospital for Children, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Goodman","sequence":"additional","affiliation":[{"name":"Center for Child &amp; Adolescent Health Research and Policy, MassGeneral Hospital for Children, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Feng","sequence":"additional","affiliation":[{"name":"Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobak","family":"Heydari","sequence":"additional","affiliation":[{"name":"Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William S.","family":"Harris","sequence":"additional","affiliation":[{"name":"Health Diagnostics Laboratory, Richmond, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Hoefner","sequence":"additional","affiliation":[{"name":"Health Diagnostics Laboratory, Richmond, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"McConnell","sequence":"additional","affiliation":[{"name":"Health Diagnostics Laboratory, Richmond, 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