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Effect of obesity on left ventricular structure and myocardial systolic function: assessment by tissue Doppler
Mustafa Murat Tumuklu1, Ilker Etikan, Bunyamin Kisacik
1Department of Cardiology, Faculty of Medicine, University of Gaziosmanpasa, Tokat, Turkey. tumuklu17@yahoo.com
Insights
Obesity leads to changes in heart structure and function, impacting left ventricle (LV) morphology and systolic performance. Advanced imaging techniques reveal subclinical cardiac alterations in obese individuals.
Area of Science:
- Cardiology
- Medical Imaging
- Obesity Research
Background:
- Obesity is a significant risk factor for cardiovascular disease, including heart failure, morbidity, and mortality.
- The direct impact of excess weight on left ventricle (LV) structure and myocardial function remains incompletely understood.
Purpose of the Study:
- To investigate the effects of obesity on left ventricle (LV) morphology and systolic function.
- Utilize Doppler echocardiography, myocardial Doppler imaging, and strain/strain rate imaging to assess cardiac function.
Main Methods:
- Compared 33 obese subjects with 34 age- and sex-matched controls without other pathologies.
- Acquired standard transthoracic Doppler echocardiography, tissue Doppler velocities, and strain/strain rate imaging data from six myocardial regions.
- Analyzed peak systolic velocity, strain, and strain rate for regional and global LV longitudinal function (glsca).
Main Results:
- Obese subjects exhibited increased LV end-diastolic volume, septal wall thickness, and left atrial diameter.
- Significant reductions in basal and mid-lateral peak systolic velocities (Sm) were observed in obese individuals.
- Obesity was associated with decreased regional strain rate, regional strain, and global longitudinal strain (glsca).
Conclusions:
- Obesity is linked to significant morphological changes in the left ventricle and left atrium.
- Subclinical alterations in left ventricle systolic function are detectable in obese individuals using strain and strain rate imaging.
- These cardiac changes occur even in the absence of overt heart disease, highlighting the importance of early detection.
Background:
Obesity is associated with heart failure, cardiovascular morbidity, and mortality. A direct effect of weight on left ventricle (LV) structure and myocardial function is not well-established.
Aim:
The aim of our study is to determine the effect of obesity on LV morphology and systolic function by using LV standard Doppler echocardiographic indices, myocardial Doppler imaging and strain/strain rate imaging indices.
Methods:
We studied 33 obese and 34 age, sex-adjusted control subjects who had no other pathological conditions. Standard transthoracic Doppler echocardiographical measurements, reconstructed spectral pulsed wave tissue Doppler velocities, strain and strain rate imaging of six different myocardial regions were obtained. Peak systolic velocity (SR), peak systolic strain (I), peak systolic strain rate (SR) for each region and as a global systolic longitidunal LV function mean of peak systolic strain of six myocardial regions (glsca) were compared.
Results:
Age, body surface area, blood pressure, and heart rate were comparable between the two groups. Obese subjects had significantly increased LV end-diastolic volume, septal wall thickness, left atrial diameter, and decreased transmitral early to late diastolic velocity ratio. In obese subjects, reconstructed spectral pulsed-wave tissue Doppler analysis showed significantly decreased basal lateral peak systolic (Sm) velocity (6.68 +/- 1.89 vs. 8.08 +/- 2.50, P < 0.05), mid lateral Sm (5.01 +/- 2.17 vs. 6.78 +/- 3.22, P < 0.05). Differences in regional strain rate (mid septal SR, 1.45 +/- 0.23 vs. 1.63 +/- 0.18, P < 0.05), regional strain (basal septum I, 19.13 +/- 3.83 vs. 22.09 +/- 4.60, P < 0.05; mid-septum I, 18.03 +/- 2.91 vs. 20.25 +/- 4.77, P < 0.05; radial I, 27.50 +/- 7.32 vs. 35.53 +/- 9.48, P < 0.05), and global strain (glsca, 19.38 +/- 1.34 vs. 21.24 +/- 2.82, P < 0.05) were identified between obese and the referent subjects.
Conclusions:
Obesity is associated with morphologic alterations in left ventricle and left atrium and subclinical changes in left ventricle systolic function which can be detected by strain and strain rate imaging even without overt heart disease.
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