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Reduced left ventricular mass after treatment of obese patients with sibutramine: An echocardiographic multicentre
A Wirth1, J Scholze, A M Sharma
1Teutoburger-Wald-Klinik, Bad Rothenfelde, Germany. alfred.wirth@lva-hannover.de
Insights
Sibutramine treatment in obese patients led to significant body weight and left ventricular mass (LVM) reduction compared to placebo. This suggests sibutramine aids in managing obesity and associated cardiac changes.
Area of Science:
- Cardiology
- Obesity Medicine
- Pharmacology
Background:
- Obesity is linked to left ventricular hypertrophy (LVH), often exacerbated by hypertension.
- Weight reduction typically decreases left ventricular mass (LVM).
- The impact of sibutramine on LVM regression in obese individuals remains unclear.
Purpose of the Study:
- To evaluate the effect of sibutramine on LVM in obese patients.
- To compare LVM changes in patients treated with sibutramine versus placebo.
Main Methods:
- A 12-week multicenter trial involving 195 obese patients (BMI 30-40 kg/m2).
- Participants received either 15 mg/day sibutramine or placebo, alongside a hypocaloric diet.
- Exclusion criteria included severe hypertension and tachycardia; LVM was assessed via echocardiography.
Main Results:
- Sibutramine group lost 6.9 kg body weight vs. 2.1 kg in placebo.
- LVM decreased by 10.9 g in the sibutramine group, while placebo showed no significant change.
- LVM changes correlated with body weight reduction, not blood pressure or heart rate.
Conclusions:
- Sibutramine treatment resulted in approximately threefold greater weight and LVM loss compared to placebo over 3 months.
- Sibutramine is a potential therapeutic option for weight management and LVM regression in obese patients, with or without hypertension.
Aim:
In obesity, left ventricular hypertrophy is frequently observed, especially in the presence of hypertension. Following body weight reduction, the left ventricular mass (LVM) is reduced. It is not known to which extent this occurs after treatment with sibutramine.
Methods:
In this multicentre trial, 195 male and female patients (18-65 years of age, body mass index 30-40 kg/m2) were treated for 12 weeks with either 15 mg/day sibutramine or placebo. They were advised to follow mildly hypocaloric reducing diets. Exclusion criteria were blood pressure values >180/110 mmHg and tachycardia (heart rate > or =100 beats/min). Echocardiography in M-mode was performed to determine LVM as well as systolic function.
Results:
Body weight was reduced by 6.9 +/- 0.3 kg under sibutramine and by 2.1 +/- 0.6 kg under placebo; body fat was reduced by 5.2 +/- 0.4 kg and 1.6 +/- 0.7 kg respectively. In the sibutramine group, LVM was reduced by 10.9 +/- 24.2 g; LVM indexed for body surface area was reduced by 2.3 +/- 11.8 g/m2 and LVM indexed for body height was reduced by 2.5 +/- 6.0 g/m(2.7). In the placebo group, LVM and LVM indices were not significantly changed. Changes in LVM correlated with reductions in body weight and initial LVM but not with changes in blood pressure or heart rate.
Conclusions:
After 3 months of treatment with sibutramine, obese patients lost about three times as much of body weight and LVM than patients treated with placebo. Therefore, sibutramine may be recommended not only to reduce body weight but also to obtain a regression of the LVM in obese patients with and without hypertension.
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