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Effects of isolated obesity on systolic and diastolic left ventricular function
M Pascual1, D A Pascual, F Soria
1Endocrinology and Nutrition Department, University Hospital Virgen de la Arrixaca, Murcia, Spain.
Insights
Isolated obesity directly impacts cardiac function, causing subclinical diastolic dysfunction even in early stages. This dysfunction correlates with body mass index (BMI) and is present across all obesity grades.
Area of Science:
- Cardiology
- Obesity Research
- Cardiovascular Physiology
Background:
- Obesity is a significant risk factor for cardiovascular morbidity and mortality.
- The direct impact of isolated obesity on cardiac function requires further elucidation.
Purpose of the Study:
- To investigate the direct effects of varying degrees of isolated obesity on left ventricular systolic and diastolic function.
- To assess echocardiographic indices in relation to obesity grades.
Main Methods:
- Studied 48 obese women and 25 normal-weight women without other pathological conditions.
- Classified obesity into slight, moderate, and severe based on body mass index (BMI).
- Utilized echocardiography to measure systolic and diastolic function, defining dysfunction based on deviations from normal values.
Main Results:
- Obese women showed increased ejection fraction, fractional shortening, and mean velocity of circumferential shortening, indicating heightened systolic function.
- Left ventricular dimensions increased, but relative wall thickness remained unchanged; no systolic dysfunction was observed.
- Subclinical diastolic dysfunction was prevalent in all obesity grades, increasing with severity (12% slight, 35% moderate, 45% severe) and correlating with BMI.
Conclusions:
- Subclinical left ventricular diastolic dysfunction is a direct consequence of isolated obesity across all grades.
- Diastolic dysfunction in obesity correlates with BMI and is accompanied by increased systolic function in early stages.
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 > or = 35 kg/m2). Echocardiographic indices of systolic and diastolic function were obtained, and dysfunction was assumed when at least two values differed by > or = 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.