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Cardiovascular remodeling in pediatric metabolic syndrome


Author: Eșanu Veronica
Degree:doctor of medicine
Speciality: 14.00.09 - Pediatrics
Year:2020
Scientific adviser: Ina Palii
doctor habilitat, associate professor (docent)
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 24 June, 2020 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document0.63 Mb / in romanian
Adobe PDF document0.59 Mb / in romanian

Thesis

CZU 616-056.52-06:616.12-053.2(043.2)

Adobe PDF document 4.72 Mb / in romanian
156 pages


Keywords

metabolic syndrome, epicardial adipose tissue, subclinical atherosclerosis, cardiac remodeling, International Diabetes Federation, children

Summary

The tehesis was performed according to the traditional criteria and included 156 pages, which comprised introduction, 5 chapters, discussions, general conclusions, recommendations, and reference list, citing 298 sources. Iconography includes 11 tables and 26 figures. The results obtained are published in 28 scientific papers.

Field of study: pediatrics and neonatology - 322.01.

Aim of the study: to assess the clinical and paraclinical parameters in children with metabolic syndrome, as well as to establish the role of MS as a determinant for cardiac remodeling onset in children aged 10-18 years.

Objectives of the study: to identify the incidence of metabolic syndrome in obese children, according to the International Diabetes Federation criteria; to study the anthropometric patterns and identify their relationship with cardiovascular remodeling indicators; to study the echocardiographic parameters of epicardial adipose tissue thickness and its correlative analysis with the anthropometric, hemodynamic, metabolic, and cardiovascular remodeling parameters; to study the left ventricular remodeling patterns in children with metabolic syndrome; to assess the subclinical atherosclerotic process by ultrasound measurement of the carotid intima-media thickness.

The scientific novelty and originality. The study was conducted on a group of children with metabolic syndrome from the Republic of Moldova via a complex assessment of clinical and paraclinical features, changes of the left ventricular myocardial structure and geometry, as well as evaluating the imaging status of the vascular endothelium and of the epicardial adipose tissue thickness. The relationship between cardiovascular remodeling and cardiovascular risk factors (anthropometric, metabolic, ultrasound, etc.) was analyzed, based on the relevant findings. Children with metabolic syndrome have been found to exhibit pathological cardiovascular remodeling patterns, as well as greater cardiac and adipose tissue measurements, but still with a preserved left ventricular function.

Theoretical significance of the study. The results of the study proved the importance of evaluating the indices of left ventricular remodeling, of the carotid intima-media thickness (index of subclinical atherosclerosis) and the epicardial adipose tissue thickness via echocardiography, thus validating the usefulness of an assessment algorithm among children with metabolic syndrome.