Sgambat K, et al. - In this prospective, controlled, longitudinal cohort study including pediatric kidney transplant recipients, researchers assessed the impacts of obesity and metabolic syndrome (MS) on left ventricular hypertrophy (LVH) and myocardial strain. Study participants were examined with respect to body mass index (BMI), waist circumference, waist-to-height ratio, fasting glucose, lipid panel, HbA1c percentage, and echocardiogram with speckle tracking analysis for strain measured at 1, 18, and 30 months post-transplant. Additionally, retrospective analysis of 35 pre-transplant echocardiograms was performed. Controls were healthy children. They found that post-transplantation cardiovascular outcomes were adversely influenced by obesity and MS. Obesity, MS, and systolic hypertension predicted higher odds of LVH in post-transplant patients. Obesity, MS, hypertension, and the combination of MS with elevated low-density lipoprotein cholesterol was independently associated with worse longitudinal strain, whereas higher estimated glomerular filtration rate had a protective effect.