Cardiac hypertrophy and diastolic function in physically well trained and in obese men

The aim of the present study was to compare cardiac hypertrophy and diastolic function in extremely obese male patients and physically active adult male subjects of similar age (means 43.0-43.4 y).

Data of male patients referred to our hospital ward in order to reduce their body weight (BW) were compared with those of physically active and nonactive healthy males.

The groups contained 21-24 male subjects, very active and moderately active subjects taking part in regular competitive or leisure time physical activity were in the two athletic groups, severely overweight patients constituted the obese group and healthy persons served as controls.

Two-dimensionally guided M-mode and Doppler recordings.

In comparison with the controls, obese patients had larger left atrial systolic and left ventricular (LV) diastolic internal diameters, LV diastolic wall thickness and muscle mass. Of the body size-related indices, only the left atrial systolic diameter index was significantly higher. LV systolic and diastolic functions were impaired as indicated by a decreased ejection fraction (EF), higher heart rate (HR), decreased E/A quotient and increased isovolumetric relaxation time. In the physically very active subjects, a thicker LV diastolic wall was seen without LV dilatation. Body size-related wall thickness and muscle mass were significantly higher than in the controls. EF and HR did not differ from those of the controls.

The most useful help to distinguish between physiological and pathological left ventricular hypertrophy can be to investigate diastolic functions. The most salient difference appeared in diastolic function, because E/A quotient was higher in the very active subjects than in the controls and it was the lowest in the obese persons.