Effects of isolated obesity on systolic and diastolic left ventricular function

• Published in: Heart (British Cardiac Society) Vol. 89; no. 10; pp. 1152 - 1156
• Main Authors: Pascual, M, Pascual, D A, Soria, F, Vicente, T, Hernández, A M, Tébar, F J, Valdés, M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01-10-2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; Copyright 2003 by Heart
• Subjects: Abnormalities; Adolescent; Adult; area under the curve of the velocity range corresponding to active mitral filling; area under the curve of the velocity range corresponding to passive mitral filling; Biological and medical sciences; BMI; Body Mass Index; Cardiac output; Cardiovascular disease; Cardiovascular Medicine; Diastole; diastolic function; Doppler effect; E/A; Echocardiography; EDD; EDV; ejection period; end diastolic diameter; end diastolic volume; end systolic diameter; end systolic volume; ESD; ESV; Evaluation; Female; fractional shortening; Heart; Heart failure; Heart ventricle, Left; Humans; isovolumic relaxation time; IVRT; maximum velocity of active mitral filling; maximum velocity of passive mitral filling; Medical sciences; Metabolic diseases; Middle Aged; mitral valve pressure half time; MV½T; Obesity; Obesity - physiopathology; PEP; Physiological aspects; posterior wall thickness; pre-ejection period; PWT; ratio of passive to active filling velocity; relative wall thickness; RWT; Statistics; Stroke Volume - physiology; Systole; systolic function; Variance analysis; VCS; Velocity; velocity of circumferential fibre shortening; Ventricular Dysfunction, Left - physiopathology; Spain; Sonography; Human; Heart failure; Obesity; Echocardiography; Prognosis; Diastole; Nutrition disorder; Cardiovascular disease; Systole; Heart disease; Left ventricle performance; Nutritional status
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heart.89.10.1152

Background: Obesity is associated with increased cardiovascular morbidity and mortality. A direct effect of isolated obesity on cardiac function is not well established. Objective: To determine the direct effect of different grades of isolated obesity on echocardiographic indices of systolic and diastolic left ventricular function. Methods: 48 obese and 25 normal weight women were studied. They had no other pathological conditions. Obesity was classed as slight (n = 17; body mass index (BMI) 25–29.9 kg/m2), moderate (n = 20; BMI 30–34.9 kg/m2), or severe (n = 11; BMI ⩾ 35 kg/m2). Echocardiographic indices of systolic and diastolic function were obtained, and dysfunction was assumed when at least two values differed by ⩾ 2 SD from the normal weight group. Results: Ejection fraction (p < 0.05), fractional shortening (p < 0.05), and mean velocity of circumferential shortening (p < 0.05) were increased in slight and moderate obesity. Left ventricular dimensions were increased (p < 0.001) but relative wall thickness was unchanged. No obese patients met criteria for systolic dysfunction. In obese subjects, the mitral valve pressure half time (p < 0.01) and the left atrial diameter (p < 0.001) were increased and the deceleration slope was decreased (p < 0.01); all other diastolic variables were unchanged. No differences were found between obesity subgroups. Subclinical diastolic dysfunction was more prevalent among obese subjects (p = 0.002), being present in two with slight obesity (12%), seven with moderate obesity (35%), and five with severe obesity (45%). BMI correlated significantly with indices of left ventricular function. Conclusions: Subclinical left ventricular diastolic dysfunction is present in all grades of isolated obesity, correlates with BMI, and is associated with increased systolic function in the early stages of obesity.